Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged over 75 years or with moderate renal impairment undergoing total knee or hip replacement

Sorrel E. Wolowacz; Neil S. Roskell; Jonathan M. Plumb; Andreas Clemens; Herbert Noack; Paul A. Robinson; Gerry Dolan; Ivan J. Brenkel

doi:10.1160/TH09-08-0579

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2010; 103(02): 360-371
DOI: 10.1160/TH09-08-0579

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged over 75 years or with moderate renal impairment undergoing total knee or hip replacement

Authors

Sorrel E. Wolowacz

¹RTI Health Solutions, Manchester, UK
Neil S. Roskell

¹RTI Health Solutions, Manchester, UK
Jonathan M. Plumb

²Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany
Andreas Clemens

²Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany
Herbert Noack

²Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany
Paul A. Robinson

³Boehringer Ingelheim Ltd, Bracknell, UK
Gerry Dolan

⁴Department of Haematology, Queen‘s Medical Centre, University Hospital, Nottingham, UK
Ivan J. Brenkel

⁵Department of Orthopaedic Surgery, Fife Acute Hospitals NHS Trust, Queen Margaret Hospital, Dunfermline, UK

Abstract

Summary

Oral dabigatran etexilate is indicated for the prevention of venous thromboembolism (VTE) in patients undergoing total knee replacement or total hip replacement. We investigated the cost-effectiveness of the 150 mg once daily (od) dose recommended for patients aged over 75 or with moderate renal impairment, from a United Kingdom National Health Service perspective. Dabigatran etexilate was compared with subcutaneous enoxaparin 40 mg od, using a decision model. Risks for VTE and bleeding were derived from subgroup analyses of the phase III trials. Dabigatran etexilate was less costly than enoxaparin; cost savings varied from £62 to £274 (base-case analyses) and were primarily due to differences in administration costs. Results were robust across a range of sensitivity analyses. Dabigatran etexilate 150 mg od is cost saving compared with enoxaparin 40 mg od in patients aged over 75 years and in patients with moderate renal impairment, with comparable efficacy and safety.

Keywords

Thromboembolism - primary prevention - total hip replacement - total knee replacement - economics

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Referenzen

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