Abstract 15521: Evaluation of Medical Costs Avoided When New Oral Anticoagulants Are Used for Extended Treatment of Venous Thromboembolism Based on Clinical Trial Results
Objective: This study evaluated avoidances in medical costs associated with clinical endpoints from randomized clinical trials that evaluated the efficacy and safety of the new oral anticoagulants (NOACs), dabigatran, rivaroxaban, and apixaban for extended treatment of patients with venous thromboembolism (VTE).
Methods: Event rates of efficacy and safety endpoints from the clinical trials, RE-SONATE, EINSTEIN-EXT, and AMPLIFY-EXT, were obtained from published literature. Incremental annual medical costs among patients with clinical events from a U.S. payer perspective were obtained from the literature or healthcare claims databases and inflation adjusted to 2013 costs. Differences in total medical costs associated with clinical endpoints for patients treated with NOACs vs. placebo were then estimated. One-way univariate and Monte Carlo sensitivity analyses were additionally carried out.
Results: The annual total medical cost avoidances were greatest for a VTE patients treated with apixaban (2.5 mg = -$4,249 per patient year (ppy), 5 mg = -$4,244 ppy), followed by those treated with rivaroxaban (-$2,948 ppy) and those treated with dabigatran (-$2,794 ppy) vs. placebo. The medical cost avoidances remained consistent under 1-way sensitivity scenarios with variations in VTE event rate, VTE cost, and MB event rate having the greatest influences on the model estimates. Additionally, the 10,000 cycles of Monte Carlo simulations demonstrated that the model estimates are robust to random parameter variations.
Conclusions: Medical costs were avoided among VTE patients taking any of the NOACs vs. placebo for extended treatment of acute VTE. Apixaban was associated with the greatest avoidance in medical costs, which was driven mainly by a greater reduced rate in recurrent VTE than other NOACs vs. placebo and also a reduction in major bleeding rate. Further evaluation is needed to validate these results in the real-world setting.
Author Disclosures: A. Almin: Consultant/Advisory Board; Significant; Novosys Health. Y. Jing: Employment; Significant; Bristol-Myers Squibb. J. Trocio: Employment; Significant; Pfizer. J. Lin: Employment; Significant; Novosys Health. M. Lingohr Smith: Employment; Significant; Novosys Health. J. Graham: Employment; Significant; Bristol-Myers Squibb.
- © 2014 by American Heart Association, Inc.