OBJECTIVES: Venous thromboembolism (VTE) is a common event in patients hospitalized due to medical illnesses, and anticoagulant prophylaxis is highly recommended, especially for high-risk patients, hospitalized for severe congestive heart failure, respiratory diseases, acute infections and inflammatory bowel diseases. Among direct oral anticoagulants, rivaroxaban proved to be non-inferior to enoxaparin – considered as standard of care - in the prevention of VTE in the intrahospital period (D10). In order to analyze the cost perspective, the objective of this work was to conduct a cost-minimization study of rivaroxaban vs enoxaparin in the prevention of VTE in hospitalized patients in the Brazilian market.

METHODS: A cost-minimization study of rivaroxaban (10mg once-daily) vs enoxaparin (40mg once-daily) was carried out, both for 10 days, from a Brazilian market perspective. Only drug costs were used in the calculations. Maximum drug prices were obtained from the list made available by the Camara de Regulação do Mercado de Medicamentos (CMED) in December / 2020 (Factory Price [PF] 18%). In addition, to reinforce the economic benefit with rivaroxaban, an analysis of savings generated with rivaroxaban was performed based on the variation in the price of enoxaparin, the lowest of which was found in a public database (ComprasNet).

RESULTS: The use of rivaroxaban in hospitalized patients has been shown to reduce 84% of treatment costs compared to enoxaparin. In the savings analysis generated by the variation in enoxaparin prices, rivaroxaban still generated a 49% cost reduction compared to the lowest available price of enoxaparin on ComprasNet.

CONCLUSIONS: At this theorical simulation, VTE prophylaxis with rivaroxaban proved to be cost-saving when compared to enoxaparin for VTE prophylaxis in hospitalized patients in the Brazilian market perspective.