title: Real-World Medical Cost Avoidance When New Oral Anticoagulants are Used Versus Warfarin for Venous Thromboembolism in the United States.
abstract: OBJECTIVE
  Real-world medical cost avoidances from a US payer perspective were estimated when new oral anticoagulants (NOACs) are used instead of warfarin for the treatment of patients with venous thromboembolism (VTE).
  
  
  METHODS
  Reductions in real-world event rates of recurrent VTE and MB were obtained by applying rate reductions from the NOACs versus warfarin trials to the Worcester population. Incremental annual medical costs among patients with VTE and MB from a US payer perspective were obtained from the literature or claims databases. Differences in total medical costs for patients treated with NOACs versus warfarin were then estimated. Univariate and Monte Carlo sensitivity analyses were additionally carried out.
  
  
  RESULTS
  The annual total medical cost avoidances versus warfarin were greatest for VTE patients treated with apixaban (-US$4440 per patient-year [ppy]), followed by those treated with rivaroxaban (-US$2971 ppy), edoxaban (-US$1957 ppy), and dabigatran (-US$572 ppy). The medical cost avoidances remained consistent under sensitivity analyses.
  
  
  CONCLUSIONS
  Based on real-world data, when any of the evaluated NOACs are used instead of warfarin for treatment of patients with acute VTE, annual medical costs are reduced. Of the NOACs, apixaban has the greatest real-world medical cost avoidance, as its use is associated with substantial reductions in both VTE and MB event rates.
authors.affiliation: Department of Medicine, Hospitalist Program, School of Medicine University of California, Irvine, CA, USA anamin@uci.edu.
authors.forename: Alpesh
authors.initials: A
authors.lastname: Amin
authors.affiliation: Bristol-Myers Squibb, CV Health Economics & Outcomes Research, Plainsboro, NJ, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Bruno
authors.affiliation: Pfizer, Inc, Global Value & Health - Outcomes & Evidence, New York, NY, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Trocio
authors.affiliation: Novosys Health, Health Economics & Outcomes Research, Green Brook, NJ, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Lin
authors.affiliation: Novosys Health, Health Economics & Outcomes Research, Green Brook, NJ, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Lingohr-Smith
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D006801:Humans; D009010:Monte Carlo Method; D014481:United States; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000191:economics*; D014859:Warfarin / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: anticoagulants; vascular disease; venous thromboembolism