Cost effectiveness of Rivaroxaban versus low molecular weight heparin and vitamin K antagonists for the treatment of deep-vein thrombosis in the Belgian healthcare setting

ORIGINAL RESEARCH, April 2015, VOL III ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.137 , Cite or Link Using DOI
Creating a Digital Object Identifier Link

A digital object identifier (DOI) can be used to cite and link to electronic documents. A DOI is guaranteed never to change, so you can use it to link permanently to electronic documents.

To find a document using a DOI

  1. Copy the DOI of the document you want to open.
    The correct format for citing a DOI is as follows: doi:10.1016/S0140-6736(08)61345-8
  2. Open the following DOI site in your browser:
    dx.doi.org
  3. Enter the entire DOI citation in the text box provided, and then click Go.
    The document that matches the DOI citation will display in your browser window.

The DOI scheme is administered by the International DOI Foundation. Many of the world's leading publishers have come together to build a DOI-based document linking scheme known as CrossRef.

Johan Maervoet, Peter Verhamme, Philippe Hainaut, Euan McLeod, Luke Bamber, Pasmans Raf, Stefaan Vansieleghem, Mimi De Ruyck

ABSTRACT

Objectives:
The aim of the present study was to evaluate the cost-effectiveness of rivaroxaban versus current standard of care for the acute treatment of deep-vein thrombosis (DVT) and prevention of recurrent DVT and pulmonary embolism (PE) in the Belgian healthcare setting.

Background: The mainstay of therapy for venous thromboembolism has been low-molecular-weight heparin (LMWH) for the initial treatment followed by oral vitamin K antagonists (VKAs) for the continued treatment during 3 to 12 months. VKAs are both effective and inexpensive, but require monitoring and carry a risk of bleeding. Rivaroxaban is the first novel oral anticoagulant that received approval for treating VTE, but there are few data on the cost-effectiveness of rivaroxaban versus LMWH/VKA.

Methods: A Markov model was designed and populated with: 1) local cost estimates, 2) comparative 2 year clinical data from the EINSTEIN-DVT phase III trial comparing rivaroxaban with LMWH / VKA and 3) data from medical literature. The results are extrapolated to a total time horizon of 40 years.

Results: Rivaroxaban was the dominant treatment option for patients requiring three months or six months treatment and cost-effective (€1,905 per QALY) for patients requiring twelve months of therapy. Sensitivity analyses showed these results were robust across a wide range of data input values.

Conclusions: The results of the present cost-effectiveness analysis indicate that rivaroxaban provides a dominant or at least a cost-effective treatment alternative to LMWH/VKA for the treatment of DVT and prevention of recurrent DVT and PE in Belgium.