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A Cost-Effectiveness Analysis of Fondaparinux Sodium Compared with Enoxaparin Sodium as Prophylaxis Against Venous Thromboembolism: Use in Patients Undergoing Major Orthopaedic Surgery

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Author Info

  • Sean D. Sullivan

    (Department of Pharmacy and Health Services, University of Washington, Seattle, Washington, USA)

  • Bruce L. Davidson

    (School of Medicine, University of Washington, Seattle, Washington, USA)

  • Susan R. Kahn

    (Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada)

  • James E. Muntz

    (Baylor College of Medicine, Houston, Texas, USA)

  • Gerry Oster

    (Policy Analysis Inc., Boston, Massachusetts, USA)

  • Gary Raskob

    (University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA)

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    Abstract

    Objective: To determine the cost effectiveness of fondaparinux sodium compared with enoxaparin sodium for prophylaxis against venous thromboembolism in patients undergoing major orthopaedic surgery. Methods: Using a cohort simulation model, two primary analyses were conducted from the perspective of the US healthcare payer. Probabilities for a trial-based analysis were obtained from patients participating in the fondaparinux clinical trial programme supplemented with data from published literature. Probabilities for a label-based analysis were estimated for a hypothetical cohort of US patients receiving either fondaparinux or enoxaparin as recommended by US FDA-approved labelling. Resource use and costs were obtained from large US healthcare databases. Outcome measures were rates of symptomatic thromboembolic events and healthcare costs. Costs were in 2003 values. Results: In the trial-based analysis, fondaparinux was estimated to prevent 15.1 symptomatic venous thromboembolic events (per 1000 patients) at 3 months for patients undergoing major orthopaedic surgery compared with enoxaparin. The cost savings (per patient) of using fondaparinux over enoxaparin are $US61 at 30 days, $US89 at 3 months, and $US155 at 5 years. In the label-based analysis, fondaparinux was estimated to prevent 17.8 venous thromboembolic events (per 1000 patients) at 3 months compared with enoxaparin, producing savings per patient of $US25 at discharge, $US112 over 1 month, $US141 over 3 months and $US234 over 5 years. Results remain robust to clinically plausible variation in input parameters and assumptions. Conclusion: Our model suggests that fondaparinux, when compared with the current standard regimen of enoxaparin for prophylaxis of venous thromboembolism in major orthopaedic surgery, improves outcomes and is cost saving from a US healthcare-payer perspective over the broad range of assumptions evaluated.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 22 (2004)
    Issue (Month): 9 ()
    Pages: 605-620
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:22:y:2004:i:9:p:605-620

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Cost-effectiveness; Enoxaparin-sodium; Fondaparinux-sodium; Low-molecular-weight-heparins; Venous-thrombosis;

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