title: Pharmacoeconomic implications of thromboprophylaxis with new oral anticoagulants after total hip or knee replacement in the USA.
abstract: BACKGROUND
  Adequate thromboprophylaxis after total hip or knee replacement (THR or TKR) is essential to reduce the incidence of venous thromboembolism (VTE) and its associated complications. Although effective, traditional anticoagulants are associated with a considerable economic burden, particularly when used outside the hospital setting. This article explores whether newer oral anticoagulants can reduce costs of VTE prophylaxis and therapy.
  
  
  METHODS
  Cost associated with vitamin K antagonists; indirect costs associated with complicated or inconvenient anticoagulation regimens, non-adherence and associated complications; potential of the newer oral anticoagulants, including direct thrombin inhibitors and direct factor Xa inhibitors, to produce indirect cost savings after THR or TKR through a potential reduction in VTE rates and administration and monitoring costs.
  
  
  CONCLUSIONS
  The use of new anticoagulants for VTE prophylaxis after THR or TKR can result in direct and indirect cost savings through improved efficacy by reducing VTE rates and decreased drug administration and monitoring costs compared with traditional anticoagulants. Future research will need to focus on cost analyses driven by clinical outcomes measured on the performance of these agents in actual clinical practice.
authors: University of Illinois at Chicago, College of Pharmacy, Center for Pharmacoeconomic Research, Department of Pharmacy Practice & Administration, 833 South Wood Street, Room 164-2, Mail Code 886, Chicago, IL 60612, USA. enutescu@uic.edu
authors: Edith A
authors: EA
authors: Nutescu
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003365:Costs and Cost Analysis; D017850:Economics, Pharmaceutical; D006801:Humans; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000191:economics* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants