| Title: |
A Real-World Cost-Effectiveness Analysis of Rivaroxaban versus Vitamin K Antagonists for the Treatment of Symptomatic Venous Thromboembolism: Lessons from the REMOTEV Registry |
| Authors: |
Kepka, Sabrina; Cordeanu, Elena-Mihaela; Zarca, Kevin; Frantz, Anne-Sophie; Ohlmann, Patrick; Andres, Emmanuel; Bilbault, Pascal; Durand-Zaleski, Isabelle; Stephan, Dominique |
| Contributors: |
Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube); École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Hôpitaux Universitaires de Strasbourg (HUS)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg); Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE); Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie - CNRS Chimie (INC-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie - CNRS Chimie (INC-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique; Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS); Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg); Hôpitaux Universitaires de Strasbourg (HUS); Nanomédecine Régénérative (NanoRegMed); Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM); AP-HP - Hôpital Cochin Broca Hôtel Dieu Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Fédération de Médecine Translationnelle de Strasbourg (FMTS); Université de Strasbourg (UNISTRA); Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Centre for Research in Epidemiology and Statistics; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) |
| Source: |
ISSN: 1010-660X. |
| Publisher Information: |
CCSD; MDPI |
| Publication Year: |
2023 |
| Subject Terms: |
rivaroxaban; vitamin K antagonist; direct oral anticoagulant; cost-effectiveness; pulmonary embolism; venous thromboembolism; [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology |
| Description: |
International audience ; Background and objectives: Venous thromboembolism (VTE) represents a health and economic burden with consequent healthcare resource utilization. Direct oral anticoagulants (DOACs) have emerged as the mainstay option for VTE treatment but few data exist on their cost-effectiveness as compared to the standard therapy (vitamin K antagonists (VKAs)). This study aimed to assess the cost-effectiveness of rivaroxaban compared to VKAs in VTE treatment by calculating the incremental cost effectiveness ratio (ICER). Materials and methods: We conducted a prospective observational study based on the REMOTEV registry, including patients hospitalized for VTE from 23 October 2013 to 31 July 2015, to evaluate the impact of the anticoagulant treatment (DOACs versus VKAs) on 6-month complications: major or clinically relevant non-major bleeding, VTE recurrence and all-cause death. Rivaroxaban was the only DOAC prescribed in this study. The ICER was calculated as the difference in costs divided by the difference in effectiveness. Results: Among the 373 patients included, 279 were treated with rivaroxaban (63.1 ± 17.9 years old; 49% men) and 94 with VKAs (71.3 ± 16.6 years old; 46% men). The mean cost was EUR 5662 [95% CI 6606; 9060] for rivaroxaban and EUR 7721 [95% CI 5130; 6304] for VKAs, while effectiveness was 0.0586 95% CI [0.0114; 0.126] for DOACs and 0.0638 [95% CI 0.0208; 0.109] for VKAs. The rivaroxaban treatment strategy was dominant with costs per patient EUR 2059 lower [95% CI −3582; −817] and a higher effectiveness of 0.00527 [95% CI −0.0606; 0.0761] compared to VKAs. Conclusions: This study provides real-world evidence that rivaroxaban is not only an efficient and safe alternative to VKAs for eligible VTE patients, but also cost-saving. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/36676804; PUBMED: 36676804; PUBMEDCENTRAL: PMC9867052 |
| DOI: |
10.3390/medicina59010181 |
| Availability: |
https://univoak.hal.science/hal-05443932; https://univoak.hal.science/hal-05443932v1/document; https://univoak.hal.science/hal-05443932v1/file/Kepka%20et%20al.%20-%202023%20-%20A%20Real-World%20Cost-Effectiveness%20Analysis%20of%20Rivaro.pdf; https://doi.org/10.3390/medicina59010181 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.5C79A06A |
| Database: |
BASE |