OBJECTIVES: To perform a cost-benefit analysis within the Peruvian context to evaluate to what extent the original molecule, Xarelto, would be a better option compared to generic anticoagulants for a patient with atrial fibrillation (AF) or deep vein thrombosis (DVT).

METHODS: Comparative analysis of costs and benefits of treatment with Xarelto and its generic in the public and private sector. We addressed it through three stages: (i) Monetary quantification of the costs (treatment value) for 14 and 9 months for AF and DVT patients, respectively. (ii) Monetary quantification of the benefits (loss of lower productivity due to greater effectiveness of a treatment). A limitation for benefits quantification was that, up to the date of this study, there were no clinical evidence of Rivaroxaban generics effectiveness; therefore, we performed a systematic review of literature on the differences in effectiveness between innovative anticoagulants and their generics, and It was selected the occurrence rates of warfarin in the USA because the interchangeability policy thresholds are the same as in Peru. (iii) Estimation and comparison of the net benefit of the alternatives evaluated

RESULTS: Considering data from Peru, innovative drug treatment direct cost would be up to S/2,104 and S/1,345 more than generic in the private and public sector, respectively. However, considering the monetary value of the loss of productivity, given our assumptions, we estimated that treatment with Xarelto would save S/6,917 and S/6,904 in comparison of the treatment with a Rivaroxaban generic in the private and public sector, respectively. These results underestimate the fact that Peruvian policy for generic drugs is incomplete in comparison to the one in the USA.

CONCLUSIONS: In Peru, Rivaroxaban generics would be less cost-beneficial than the innovative drug for AF and DVT patients. Although the generic would have lower direct costs, the savings would be greater.