Key result
Apixaban significantly reduced mean total all-cause direct medical and non-medical costs per patient per month compared to vitamin K antagonists (€771.60 vs. €883.66) in patients hospitalized for acute VTE.
Why the study?
Apixaban has shown non-inferior efficacy and better safety than VKAs in VTE, but whether healthcare resource use and direct medical and non-medical costs differed between them in France was unknown.
Does apixaban reduce healthcare resource utilization and costs compared to VKAs in anticoagulant-naïve adults hospitalized with VTE without cancer?
Cohort (n=15,006)
Does apixaban reduce healthcare resource utilization and costs compared to VKAs in anticoagulant-naïve adults hospitalized with VTE without cancer?
Absolute Event Rate: 771.6% vs 883.66%
p-value: p=<0.0001
Apixaban is associated with significantly lower all-cause healthcare costs compared to VKAs in patients hospitalized for acute VTE.
Apixaban was associated with lower costs versus VKAs in acute VTE; leaves open need for randomized confirmation of economic outcomes.
INTRODUCTION: The direct oral anticoagulant (DOAC) apixaban has shown to have non-inferior efficacy and better safety than vitamin K antagonists (VKAs) in patients with venous thromboembolism (VTE). We determined whether healthcare resource use (HCRU) and direct all-cause medical and non-medical costs in patients with VTE in France differed between VKAs and apixaban. METHODS: A retrospective cohort study was conducted using French national health data from January 2013-June 2018 for anticoagulant-naïve adults hospitalized with VTE. All-cause costs and HCRU per patient per month (PPPM) were compared between apixaban and VKA cohorts created by 1:1 propensity score matching. Two-part models with bootstrapping were used to calculate marginal effects for costs and HCRU. RESULTS: The matched VKA and apixaban cohorts each comprised 7503 patients. Compared to VKAs, patients prescribed apixaban had significantly lower (P < 0.0001) mean all-cause costs PPPM for outpatient visits (€438.54 vs. €455.58), overall laboratory tests (€21.26 vs. €83.73), and hospitalizations (€249.48 vs. €343.82), but significantly higher (P < 0.0001) mean all-cause costs PPPM for overall drugs (€97.06 vs. €69.56) and medical procedures (€42.12 vs. €35.50). Mean total all-cause direct medical costs (€687.93 vs. €798.70) and total all-cause direct medical and non-medical costs (€771.60 vs. €883.66) were significantly lower (P < 0.0001) for apixaban. Mean HCRU PPPM showed similar trends. Subgroup analyses showed that, among patients with recurrent VTE, patients prescribed apixaban had significantly lower (P < 0.0001) all-cause costs PPPM for total medical costs (€17.26 vs. €18.12) and total all-cause direct medical and non-medical costs (€18.37 vs. €19.20) than patients prescribed VKAs. Similarly, among patients with bleeding, patients prescribed apixaban had significantly lower (P < 0.0001) all-cause costs PPPM for total medical costs (€15.34 vs. €32.61) and total all-cause direct medical and non-medical costs (€16.23 vs. €34.63) than patients prescribed VKAs. CONCLUSION: Compared to VKAs, apixaban may be cost-saving in the treatment of patients hospitalized for acute VTE.
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Mokgokong et al. (2022) conducted a cohort in Venous thromboembolism without cancer (n=15,006). Apixaban vs. Vitamin K antagonists was evaluated on Mean total all-cause direct medical and non-medical costs per patient per month (p=<0.0001). Apixaban significantly reduced mean total all-cause direct medical and non-medical costs per patient per month compared to vitamin K antagonists (€771.60 vs. €883.66) in patients hospitalized for acute VTE.
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