Clinical and economic analysis of the use of apixaban for the treatment of venous thromboembolic events
https://doi.org/10.20996/1819-6446-2015-11-6-601-606
Abstract
Aim. Pharmacoeconomic analysis of apixaban use compared to conventional therapy in patients with venous thromboembolism (VTE).
Material and methods. Economic evaluation was performed from a position of the health care system. The cost analysis, "cost-effectiveness" analysis, "impact on the budget” analysis, and sensitivity analysis were fulfilled.
Results. In real clinical practice in hospitals direct medical costs of apixaban treatment of deep vein thrombosis and pulmonary embolism make up 2331.67 and 3142.98 rubles, respectively, while the costs of the standard therapy - 6192.15 and 6225.75 rubles. Potential resource savings will reduce 2.65 times the cost of the health system. The share of the costs of treatment of adverse effects (bleeding) in the conventional therapy group was 4.8 times higher than the costs in apixaban group. The results of analysis of the effect on the budget show a decrease in the load on the budget when apixaban was included in the treatment regimen of VTE. Potential resource savings of the health system in the treatment of 1,000 patients with apixaban will account 3,911,860 rubles in comparison with conventional therapy.
Conclusion. The inclusion of apixaban in the therapy of VTE can significantly reduce the burden on the budget of the health care system.
About the Author
O. V. Shatalova
Volgograd State Medical University. Pavshikh Bortsov pl., 1, Volgograd, 400131 Russia
Russian Federation
Russian Federation
References
1. Richard H., White R.H. The epidemiology of venous thromboembolism. Circulation 2003;107(23 Suppl 1):I4-I8.
2. Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem.// Best Pract Res Clin Haematol 2012; 25: 235-42.
3. Bĕlohlávek J, Dytrych V, Linhart A. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013; 18: 129-38.
4. Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet 2012;379: 1835-46.
5. Mahan CE, Holdsworth MT, Welch SM, et al. Deep-vein thrombosis: a United States cost model for apreventable and costly adverse event. Thromb Haemost 2011;106:405-15.
6. Petrov VI, Shatalova OV, Maslakov AS. Monitoring of anticoagulant therapy in patients with deep vein thrombosis. Kardiovaskulyarnaya Terapiya i Profilaktika2014; 13 (4): 54-9. In Russian (Петров В.И., Шаталова О.В., Маслаков А.С. Мониторинг антикоагулянтной терапии у пациентов с тромбозом глубоких вен. Кардиоваскулярная Терапия и Профилактика 2014;13(4):54-9).
7. Petrov VI, Maslakov AS, Shatalova OV et al. Analysis of the consumption of drugs in the treatment of deep vein thrombosis of the lower limbs. Vestnik Volgogradskogo Gosudarstvennogo Meditsinskogo Universiteta 2013; 4 (48): 12-5. In Russian (Петров В.И., Маслаков А.С., Шаталова О.В., и др. Анализ потребления лекарственных средств при лечении тромбоза глубоких вен нижних конечностей. Вестник Волгоградского Государственного Медицинского Университета 2013;4(48):12-5.
8. National guidelines for diagnosis, treatment and prevention of venous thromboembolic complications. Flebologiia 2010; 4: 3-37. In Russian (Национальные рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология 2010; 4: 3-37).
9. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141: Suppl:e419S-e494S.
10. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014;35(43):3033-69.
11. Instructions for use of the drug for medical-Application-of Elikvis. Available at:http://grls.rosminzdrav.ru/ImgInstr.aspx?folder=ScanVavilova&Filepath=Ne_trebuet_vneseniaNet_ND_IZM464752IP&idReg=85745&isOld=1&fileType=jpg&pfolder=2. Accessed by 12/18/2015. In Russian (Инструкция по применению лекарственного препарата для медицинского применения Эликвис. Доступно на: http://grls.rosminzdrav.ru/ImgInstr.aspx?folder=ScanVavilova&Filepath=Ne_trebuet_vneseniaNet_ND_IZM464752IP&idReg=85745&isOld=1&fileType=jpg&pfolder=2. Проверено 18.12.2015).
12. The system of standardization in the health of the Russian Federation. The industry standard clinicoeconomic study. General provisions 91500.14.0001-2002. The Ministry of Health of the Russian Federation. Order from 27.05.2002 №163. In Russian (Система стандартизации в здравоохранении Российской Федерации. Отраслевой стандарт клинико-экономического исследования. Общие положения 91500.14.0001-2002. Министерство Здравоохранения Российской Федерации. Приказ от 27.05.2002 №163).
13. Khabriev RU, Kulikov AY, Arinina EE. Methodological bases farmakoeko-Economic Analysis. Moscow: Medicine; 2011. In Russian (Хабриев Р.У., Куликов А.Ю., Аринина Е.Е. Методологические основы фармакоэкономического анализа. М.: Медицина; 2011).
14. Sullivan S., Mauskopf J., Augustovski F., et al. Budget ImpactAnalysis—Principles of GoodPractice: Report of the ISPOR 2012 Budget Impact Analysis Good Practice IITask Force. Value in health 2014; 17(1): 5-14.
15. Agnelli G, Buller H, Cohen A, et al.; AMPLIFY Investigators. Oral Apixaban for the Treatment of Acute Venous Thromboembolism. N Engl J Med 2013; 369:799-808.
16. The collective agreement CHI 2015, Volgograd. Available at: http://www.volgatfoms.ru/anorm_gensogl.html. Accessed by 12/18/2015. In Russian (Генеральное тарифное соглашение ОМС на 2015 год, г. Волгоград. Доступно на: http://www.volgatfoms.ru/anorm_gensogl.html. Проверено 18.12.2015).
Review
For citations:
Shatalova O.V. Clinical and economic analysis of the use of apixaban for the treatment of venous thromboembolic events. Rational Pharmacotherapy in Cardiology. 2015;11(6):601-606. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-6-601-606
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