COST-MINIMIZATION ANALYSIS OF APIXABAN VERSUS STANDARD-OF-CARE ENOXAPARIN FOR THROMBOPROPHYLAXIS AFTER HIP OR KNEE REPLACEMENT IN ALGERIA
Author(s)
Mourad OUALI, Medical Doctor specialist1, jalal Atieh, bachelor of pharmacy2, Sabrina Belahnche, bachelor of pharmacy3, Imene Hana, Doctor of pharmacy3, Khader I. Al-Habash, Sr., PharmD2.
1Mustapha Bacha University Hospital Center, Alger, Algeria, 2Market Access, Hikma Pharmaceuticals, Amman, Jordan, 3Market Access, hikma Pharmaceuticals, Algiers, Algeria.
1Mustapha Bacha University Hospital Center, Alger, Algeria, 2Market Access, Hikma Pharmaceuticals, Amman, Jordan, 3Market Access, hikma Pharmaceuticals, Algiers, Algeria.
OBJECTIVES: Venous thromboembolism is a major preventable complication following total hip replacement (THR) and total knee replacement (TKR). Enoxaparin is commonly used as standard-of-care for thromboprophylaxis in Algeria. This study evaluated the economic impact of apixaban versus standard-of-care enoxaparin for thromboprophylaxis in patients undergoing total hip or knee replacement in Algeria from the payer perspective.
METHODS: A cost-minimization analysis was developed based on evidence suggesting comparable efficacy and similar or improved safety between apixaban and enoxaparin for postoperative thromboprophylaxis according to ADVANCE-2 and ADVANCE-3 trials. The model compared total costs associated with apixaban 2.5 mg twice daily and enoxaparin 40 mg once daily. Postoperative treatment duration was assumed to be 35 days for THR and 10 days for TKR based on the ADVANCE-2 and ADVANCE-3 trials. The annual number of eligible procedures in Algeria was estimated using proxy data from countries with similar socioeconomic and demographic characteristics. Costs included drug acquisition, administration, and clinically relevant non-major bleeding events. Cost inputs were adjusted using Algeria’s Consumer Price Index.
RESULTS: The estimated annual number of procedures was 10,062 THR and 4,472 TKR. The treatment cost per patient for THR was 5,200 DZD for apixaban compared with 17,185 DZD for enoxaparin, and 1,300 DZD for apixaban compared to 2,945 for enoxaparin for treatment of TKR. Apixaban was also associated with lower clinically relevant non-major bleeding costs, estimated at 1,096 DZD per patient compared with 1,625 DZD for enoxaparin. Overall, national annual cost savings associated with apixaban were estimated at 176,571,384 DZD.
CONCLUSIONS: From the Algerian payer perspective, apixaban was projected to be a cost-saving alternative to standard-of-care enoxaparin for thromboprophylaxis after hip or knee replacement. Savings were driven primarily by lower drug acquisition and administration costs, with additional reductions in bleeding related costs. Apixaban may offer a cost saving thromboprophylaxis option for the Algerian healthcare payer.
METHODS: A cost-minimization analysis was developed based on evidence suggesting comparable efficacy and similar or improved safety between apixaban and enoxaparin for postoperative thromboprophylaxis according to ADVANCE-2 and ADVANCE-3 trials. The model compared total costs associated with apixaban 2.5 mg twice daily and enoxaparin 40 mg once daily. Postoperative treatment duration was assumed to be 35 days for THR and 10 days for TKR based on the ADVANCE-2 and ADVANCE-3 trials. The annual number of eligible procedures in Algeria was estimated using proxy data from countries with similar socioeconomic and demographic characteristics. Costs included drug acquisition, administration, and clinically relevant non-major bleeding events. Cost inputs were adjusted using Algeria’s Consumer Price Index.
RESULTS: The estimated annual number of procedures was 10,062 THR and 4,472 TKR. The treatment cost per patient for THR was 5,200 DZD for apixaban compared with 17,185 DZD for enoxaparin, and 1,300 DZD for apixaban compared to 2,945 for enoxaparin for treatment of TKR. Apixaban was also associated with lower clinically relevant non-major bleeding costs, estimated at 1,096 DZD per patient compared with 1,625 DZD for enoxaparin. Overall, national annual cost savings associated with apixaban were estimated at 176,571,384 DZD.
CONCLUSIONS: From the Algerian payer perspective, apixaban was projected to be a cost-saving alternative to standard-of-care enoxaparin for thromboprophylaxis after hip or knee replacement. Savings were driven primarily by lower drug acquisition and administration costs, with additional reductions in bleeding related costs. Apixaban may offer a cost saving thromboprophylaxis option for the Algerian healthcare payer.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE467
Topic
Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)