title: Cost-effectiveness of rivaroxaban versus heparins for prevention of venous thromboembolism after total hip or knee surgery in Sweden.
abstract: OBJECTIVE
  The objective of this study was to evaluate the cost-effectiveness of rivaroxaban versus the low-molecular-weight heparins (LMWH) enoxaparin and dalteparin for the prevention of venous thromboembolism (VTE) after total hip replacement and total knee replacement in Sweden.
  
  
  METHODS
  The model included acute venous thromboembolic events and long-term complications over a 5-year time horizon represented by an acute and a chronic phase with 1-year cycles. Transition probabilities were derived from the Regulation of Coagulation in Orthopaedic Surgery to Prevent Deep Vein Thrombosis and Pulmonary Embolism (RECORD) clinical trials.
  
  
  RESULTS
  In patients undergoing total hip replacement, the incremental cost per additional quality-adjusted life-year of extended prophylaxis for 35 days with rivaroxaban versus 14 days of prophylaxis with enoxaparin or dalteparin was SEK29,400 and SEK35,400, respectively. In total knee replacement patients, 14 days of rivaroxaban dominated 14 days of LMWH as prophylaxis for VTE.
  
  
  CONCLUSIONS
  The results of the economic model consistently showed that, over a 5-year period, rivaroxaban is a cost-effective alternative to 14 days of LMWH for VTE prophylaxis in Sweden.
authors.affiliation: Orthopedic Department, Örebro University Hospital, USÖ SE 70185, Örebro, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Ryttberg
authors.forename: Alex
authors.initials: A
authors.lastname: Diamantopoulos
authors.forename: Fiona
authors.initials: F
authors.lastname: Forster
authors.forename: Michael
authors.initials: M
authors.lastname: Lees
authors.forename: Anina
authors.initials: A
authors.lastname: Fraschke
authors.forename: Ingela
authors.initials: I
authors.lastname: Björholt
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D003362:Cost-Benefit Analysis; D006493:Heparin / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D018803:Models, Economic; D009025:Morpholines / Q000191:economics / Q000627:therapeutic use*; D000069552:Rivaroxaban; D013548:Sweden; D013876:Thiophenes / Q000191:economics / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D009025:Morpholines; D013876:Thiophenes; D006493:Heparin; D000069552:Rivaroxaban