COST-EFFECTIVENESS OF THE INITIAL TREATMENT OF VENOUS THROMBOEMBOLISM FROM THE BRAZILIAN PRIVATE HEALTHCARE SYSTEM PERSPECTIVE
Author(s)
Alexandre RF1, Squiassi HB1, Santana CF1, Nascimento R1, Lucchetta R2, Riveros BS2, Pedro GO3, Nita ME3
1Pfizer, São Paulo, Brazil, 2Federal University of Parana, Curitiba, Brazil, 3SolVE, São Paulo, Brazil
OBJECTIVES: To assess the cost-effectiveness of apixaban versus other anticoagulants in the initial treatment of venous thromboembolism (VTE) from the Brazilian Private Healthcare System (PHS) perspective. METHODS: An economic evaluation of apixaban versus other anticoagulants (dabigatran, rivaroxaban and standard of care (SOC) – enoxaparin and warfarin) was performed using a Markov-associated decision tree model that accompanied patients with VTE over a 5-year time horizon. For all comparators, a single treatment of 6 months was considered. The clinical and economic outcomes considered were, respectively, life years saved (LY) and medical direct costs. An annual discount rate of 5% was considered for the latter. A probabilistic sensitivity analysis (PSA) was also performed, considering variations in efficacy, risks of long-term events and costs. The cost-effectiveness acceptability curve ranged from BRL 0 to 100,000. RESULTS: Total costs of dabigatran, rivaroxaban, apixaban and SOC were, respectively, BRL 2437, BRL 1464, BRL 1427 and BRL 684, with effectiveness of 4.45 LY for all treatments. In the PSA, the efficiency of all treatments had little variation because of the low incidence of thromboembolic events or bleeding. The acceptability curve indicated a 100%, 70% and 0% probability in apixaban to be more cost-effective versus dabigatran, rivaroxaban and SOC, respectively, regardless of willingness to pay. CONCLUSIONS: It was possible to observe similar efficacy among all comparators, with apixaban being the treatment with the lowest cost, that is, more efficient compared to dabigatran and rivaroxaban, but not to SOC, in the treatment of VTE in the Brazilian PHS.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PHP85
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Multiple Diseases