Evaluation of medical costs associated with use of new oral anticoagulants compared with standard therapy among venous thromboembolism patients

Figures & data

Table 1. Clinical event rates (per patient-year) among venous thromboembolism (VTE) patients treated with new oral anticoagulants (NOACs) and standard therapies (Control).

Outcome	Dabigatran vs Control (per patient year)	Rivaroxaban vs Control (per patient year)	Apixaban vs Control (per patient year)	Edoxaban vs Control (per patient year)
Efficacy end-point
Recurrent VTE*	2.35% vs 2.15%	2.07 vs 2.30%	2.26% vs 2.69%	1.60% vs 1.94%
DifferenceΔ [CI]	0.20% [−0.52%, 1.22%]	−0.23% [−0.78%, 0.44%]	−0.43% [−1.08%, 0.49%]	−0.34% [−0.78%, 0.27%]
Safety end-points
Major bleedings	1.37% vs 1.80%	0.97% vs 1.75%	0.56% vs 1.82%	1.36% vs 1.60%
DifferenceΔ [CI]	−0.43% [−0.91%, 0.32%]	−0.78% [−1.10%, −0.37%]	−1.26% [−1.51%, −0.82%]	−0.24% [−0.66%, 0.34%]
Clinically relevant  non-major bleedings	4.01% vs 6.87%	8.57% vs 8.41%	3.85% vs 8.00%	7.24% vs 8.93%
DifferenceΔ [CI]	−2.87% [−4.01%, −1.26%]	0.17% [−0.97%, 1.47%]	−4.15% [−4.96%, −3.20%]	−1.69% [−2.86%, −0.62%]
Other minor bleedings	12.50% vs 16.79%	18.91% vs 18.00%	11.21% vs 16.14%	13.26% vs 15.36%
DifferenceΔ [CI]	−4.29% [−5.86%, −2.50%]	0.91% [−0.73%, 2.70%]	−4.93% [−6.37%, −3.28%]	−2.10% [−3.43%, −0.61%]

*Included recurrent VTE and VTE-related death as defined in the clinical trials; ΔDifference = NOAC − Control.

CI, confidence interval.

Table 2. Medical cost differences among venous thromboembolism (VTE) patients treated with new oral anticoagulants (NOACs) vs standard therapies.

Outcome	Dabigatran ($/patient-year)	Rivaroxaban ($/patient-year)	Apixaban ($/patient-year)	Edoxaban ($/patient-year)
Efficacy end-point
Recurrent VTE	$114	−$132	−$252	−$197
Safety end-points
Major bleedings	−$195	−$354	−$572	−$109
Clinically relevant non-major bleedings	−$61	$4	−$89	−$36
Other minor bleedings	−$4	$1	−$5	−$2
Total medical cost	−$146	−$482	−$918	−$344

Negative numbers indicate cost reduction vs. standard therapies.

Table 3. Alternative scenario analysis: medical cost differences among venous thromboembolism (VTE) patients treated with new oral anticoagulants (NOACs) vs standard therapies—with treatment duration normalized to 6 months.

Outcome	Dabigatran ($/patient-year)	Rivaroxaban ($/patient-year)	Apixaban ($/patient-year)	Edoxaban ($/patient-year)
Efficacy end-point
Recurrent VTE	$130	−$135	−$317	−$148
Safety end-points
Major bleedings	−$211	−$320	−$680	−$83
Clinically relevant non-major bleedings	−$67	$0	−$105	−$28
Other minor bleedings	−$5	$1	−$6	−$2
Total medical cost	−$153	−$454	−$1108	−$261

Negative numbers indicate cost reduction vs. standard therapies.

Figure 1. Univariate sensitivity analyses of medical cost differences of new oral anticoagulants (NOACs) vs standard therapies.

Figure 2. Distribution of total medical cost differences from 10,000 cycles of Monte Carlo simulation: new oral anticoagulants (NOACs) vs standard therapies.