Economic impact of venous thromboembolism after hip and knee arthroplasty: potential impact of rivaroxaban

Abstract

The number of total hip and knee arthroplasties is increasing, with a consequent rise in the number of patients at risk of venous thromboembolism. Each such event is associated with the risk of morbidity and mortality, plus substantial healthcare costs. Consequently, the American College of Chest Physicians guidelines recommend low-molecular-weight heparins, fondaparinux or vitamin K antagonists (usually warfarin) after total hip and knee arthroplasty. However, such agents are also associated with healthcare costs for administration and monitoring. New oral anticoagulants in development may reduce post-arthroplasty symptomatic thromboembolic events and produce potential savings for the healthcare system. This brief article outlines such potential savings with rivaroxaban based on the results of the REgulation of Coagulation in ORthopaedic surgery to prevent Deep vein thrombosis and pulmonary embolism (RECORD) program.

Keywords::

• anticoagulants
• arthroplasty
• economics
• enoxaparin
• rivaroxaban
• venous thromboembolism

Financial & competing interests disclosure

This study was supported by Bayer Schering Pharma AG and Johnson & Johnson Pharmaceutical Research & Development, L.L.C. Richard Friedman has received research or institutional support from Boehringer Ingelheim and Astellas US and has been a paid consultant for Astellas US, Boehringer Ingelheim, Johnson & Johnson and DJO Surgical. Michael Lees was an employee of Bayer HealthCare plc and Nishan Sengupta is an employee of Johnson & Johnson, L.L.C. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial support was provided by Chris Thomas, with funding from Bayer Schering Pharma AG and Johnson & Johnson Pharmaceutical Research & Development, L.L.C.