Cost-effectiveness of rivaroxaban compared with enoxaparin plus warfarin for the treatment of hospitalised acute deep vein thrombosis in China
Cost-effectiveness of rivaroxaban compared with enoxaparin plus warfarin for the treatment of hospitalised acute deep vein thrombosis in China
复制标题
利伐沙班与依诺肝素加华法林治疗中国住院急性深静脉血栓的成本效益比较
DOI：
10.1136/bmjopen-2020-038433
复制
发表时间：
2020-07
期刊：
影响因子：
2.9
通讯作者：
Jingjing Wu
中科院分区：
文献类型：
--
作者：
Li Yang;Jingjing Wu
目的中国存在利伐沙班与照护标准(SOC)对照的经济学评价数据有限。本分析的目的是评价利伐沙班与目前的SoC(依诺肝素与华法林重叠)治疗中国急性深静脉血栓形成(DVT)的成本-效果。方法采用马尔可夫模型，从支付者的角度评估利伐沙班或依诺肝素/华法林治疗DVT患者的费用和质量调整生命年。从爱因斯坦-深静脉血栓试验中获得的临床数据被用来估计转移概率。中国卫生资源使用、单位成本和效用参数的数据收集自以前发表的文献，并用于估计总成本和QALY。模型的时间跨度设定为5年，周期长度为3个月。对预计费用适用5%的贴现率。进行了单向敏感性分析和概率敏感性分析，以评估不确定性对结果的影响。结果利伐沙班治疗增加了0.008个QALY，且与依诺肝素/华法林相比总成本较低(分别为4744.4美元和5572.4美元)，证明它是一种节省成本的治疗策略。结果主要是对深静脉血栓对依诺肝素/华法林的住院时间、每天的住院费用以及利伐沙班治疗的患者和依诺肝素/华法林治疗的患者住院时间的差异敏感。结论利伐沙班用于中国地区住院急性DVT患者的抗凝治疗比依诺肝素/华法林节省成本。试验注册号NCT00440193；结果公布。
Objective Limited economic evaluation data for rivaroxaban compared with standard of care (SoC) exists in China. The objective of this analysis was to evaluate the cost-effectiveness of rivaroxaban compared with current SoC (enoxaparin overlapped with warfarin) for the treatment of acute deep vein thrombosis (DVT) in China. Methods A Markov model was adapted from a payer’s perspective to evaluate the costs and quality-adjusted life years (QALYs) of patients with DVT treated with rivaroxaban or enoxaparin/warfarin. Clinical data from the EINSTEIN-DVT trial were obtained to estimate the transition probabilities. Data on Chinese health resource use, unit costs and utility parameters were collected from previously published literature and used to estimate the total costs and QALYs. The time horizon was set at 5 years and a 3-month cycle length was used in the model. A 5% discount rate was applied to the projected costs. One-way sensitivity analyses and probabilistic sensitivity analyses were undertaken to assess the impact of uncertainty on results. Results Rivaroxaban therapy resulted in an increase of 0.008 QALYs and was associated with lower total costs compared with enoxaparin/warfarin (US$4744.4 vs US$5572.4, respectively), demonstrating it to be a cost-saving treatment strategy. The results were mainly sensitive to length of hospitalisation due to DVT on enoxaparin/warfarin, cost per day of hospitalisation and the difference in length of stay of rivaroxaban-treated and enoxaparin/warfarin-treated patients. Conclusion Rivaroxaban therapy resulted in a cost saving compared with enoxaparin/warfarin for the anticoagulation treatment of patients with hospitalised acute DVT in China. Trial registration number NCT00440193; Post-results.
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DOI：
10.1302/0301-620x.91b5.21691
发表时间：
2009-05-01
影响因子：
--
作者：
Eriksson, B. I.;Kakkar, A. K.;Lassen, M. R.
通讯作者：
Lassen, M. R.
影响因子：
7.5
作者：
Seaman, Craig D.;Smith, Kenneth J.;Ragni, Margaret V.
通讯作者：
Ragni, Margaret V.
DOI：
10.1302/0301-620x.92b3.24657
发表时间：
2010
期刊：
The Journal of bone and joint surgery. British volume
影响因子：
--
作者：
R. Clayton;P. Gaston;Frcsed;Tr Orth;C. Howie;B. Eriksson;Ajay Kakkar;A. Turpie;M. Gent;M. Lassen;Warwick;Friedman Rj;Agnelli G
通讯作者：
R. Clayton;P. Gaston;Frcsed;Tr Orth;C. Howie;B. Eriksson;Ajay Kakkar;A. Turpie;M. Gent;M. Lassen;Warwick;Friedman Rj;Agnelli G
影响因子：
2.4
作者：
P. Lefebvre;C. Coleman;B. Bookhart;Si-Tien Wang;S. Mody;Kevin N. Tran;D. Zhuo;L. Huynh;E. Nutescu
通讯作者：
P. Lefebvre;C. Coleman;B. Bookhart;Si-Tien Wang;S. Mody;Kevin N. Tran;D. Zhuo;L. Huynh;E. Nutescu
影响因子：
9.6
作者：
Kearon, Clive;Akl, Elie A.;Moores, Lisa
通讯作者：
Moores, Lisa