Análisis coste-efectividad de rivaroxabán en la prevención de la enfermedad tromboembólica venosa en Espa?a

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• 作者：Max Brosa (1)
  Manuel Monreal (2)
  Carme Pi?ol (3)
  
• 关键词：coste ; efectividad ; rivaroxabán ; enfermedad tromboembólica venosa ; cirugía ortopédica mayor ; Espa?a ; cost ; effectiveness ; rivaroxaban ; venous thromboembolic disease ; major orthopedic surgery ; Spain
• 刊名：PharmacoEconomics Spanish Research Articles
• 出版年：2012
• 出版时间：February 2012
• 年：2012
• 卷：9
• 期：1
• 页码：35-46
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• 作者单位：Max Brosa (1)
  Manuel Monreal (2)
  Carme Pi?ol (3)
  
  1. c/Josep Irla i Bosch, 5- Primera Planta, 08034, Barcelona, Espa?a
  2. Servicio de Medicina Interna, Hospital Germans Trias i Pujol. Badalona, Barcelona, Espa?a
  3. Bayer Healthcare, Barcelona, Espa?a
  
• ISSN：1989-5453

文摘

Introduction: Venous thromboembolic disease (VTE) is a common and serious disease that causes a great impact on the National Health System (NHS). The aim of this study was to perform a cost-effectiveness analysis of rivaroxaban versus enoxaparin in preventing VTE in patients undergoing major orthopedic surgery in Spain from the perspective of the NHS. Methods: A decision analytic model of rivaroxaban versus enoxaparin was used to replicate the short-term results of the RECORD studies and to model the 5-year costs and outcomes of VTE in two cohorts of patients: patients undergoing total hip replacement (THR) and patients undergoing total knee replacement (TKR). The analysis was conducted from the perspective of the NHS. All costs were in euros of 2008. Costs and effects were discounted at a rate of 3% annually. Results: Rivaroxaban was more effective than enoxaparin (16 and 29 fewer symptomatic events per 1,000 patients in THR and TKR, respectively), which resulted in a moderate gain in terms of quality-adjusted life year (QALY) (11 and 22 QALYs gained per 1000 patients treated in THR and TKR, respectively). The lower incidence of complications also resulted in a lower total cost for rivaroxa-ban over enoxaparin, showing cost savings of ?30 and ?151 (for THR and TKR respectively). The results of the probabilistic sensitivity analysis showed the robustness of the analysis when changing the main parameters of the model. Conclusions: Reducing the incidence of VTE, with major economic consequences in the short and medium term, makes rivaroxaban an option not only more effective but also less costly compared with enoxaparin.