OBJECTIVES: To estimate the cost utility and budget impact on the Argentinean health system of implementation of anticoagulation clinics (ACs) (with and without use of point-of-care [POC] CoaguChek® devices [Roche Diagnostics International Ltd]) compared with the traditional laboratory method (non-AC settings) for the management of anticoagulated patients.

METHODS: For the cost-utility analysis, a cohort based state transition model was designed to compare costs and health outcomes of implementing ACs for outpatient management of anticoagulated patients. The budget impact analysis uses an analytical model to estimate the differential costs of implementing an AC and the expected adverse events avoided, and the differential costs of an INR determination using a POC device rather than conventional laboratory.

RESULTS: Considering a 5% discount rate, the use of ACs generates 13.9 additional quality-adjusted life-years (0.014 per person) and 12.5 additional life-years (0.013 per person). The results of the budget impact analysis show AC implementation generates savings from the first year of implementation, with savings of AR $265,325 by Year 5. The addition of POC devices in the ACs also generates savings as early as the first year of implementation, with savings of AR $488,072 by Year 5 (AR $488 per patient).

CONCLUSIONS: ACs are cost effective and generate notable savings in the treatment of patients on long-term oral anticoagulant therapy when compared with non-AC settings. These savings are considerably higher when POC devices are added as part of the patient management.