Key result
Rivaroxaban prophylaxis cost SEK29,400 to SEK35,400 per QALY gained versus LMWH after hip replacement, and dominated LMWH after knee replacement over a 5-year period.
Why the study?
Does rivaroxaban improve cost-effectiveness compared to LMWH for VTE prevention in patients undergoing total hip or knee replacement?
Does rivaroxaban improve cost-effectiveness compared to LMWH for VTE prevention in patients undergoing total hip or knee replacement?
Effect estimate: SEK29,400 vs enoxaparin and SEK35,400 vs dalteparin per QALY (hip); dominated (knee)
Rivaroxaban is a cost-effective alternative to LMWH for VTE prophylaxis following major orthopedic surgery in Sweden.
Supports rivaroxaban consideration for VTE prophylaxis in Sweden; leaves open generalizability and real-world confirmation elsewhere.
AIMS: The objective of this study was to evaluate the cost-effectiveness of rivaroxaban versus the low-molecular-weight heparins (LMWH) enoxaparin and dalteparin for the prevention of venous thromboembolism (VTE) after total hip replacement and total knee replacement in Sweden. METHODS: The model included acute venous thromboembolic events and long-term complications over a 5-year time horizon represented by an acute and a chronic phase with 1-year cycles. Transition probabilities were derived from the Regulation of Coagulation in Orthopaedic Surgery to Prevent Deep Vein Thrombosis and Pulmonary Embolism (RECORD) clinical trials. RESULTS: In patients undergoing total hip replacement, the incremental cost per additional quality-adjusted life-year of extended prophylaxis for 35 days with rivaroxaban versus 14 days of prophylaxis with enoxaparin or dalteparin was SEK29,400 and SEK35,400, respectively. In total knee replacement patients, 14 days of rivaroxaban dominated 14 days of LMWH as prophylaxis for VTE. CONCLUSION: The results of the economic model consistently showed that, over a 5-year period, rivaroxaban is a cost-effective alternative to 14 days of LMWH for VTE prophylaxis in Sweden.
No takes yet. Share an insight, caveat, or question.
Ryttberg et al. (2011) studied Venous thromboembolism after total hip or knee surgery. Rivaroxaban vs. Low-molecular-weight heparins (enoxaparin and dalteparin) was evaluated on Incremental cost per additional quality-adjusted life-year (QALY) (SEK29,400 vs enoxaparin and SEK35,400 vs dalteparin per QALY (hip); dominated (knee)). Rivaroxaban prophylaxis cost SEK29,400 to SEK35,400 per QALY gained versus LMWH after hip replacement, and dominated LMWH after knee replacement over a 5-year period.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: