Evidence mapPaperPMID 28608312Full record

ArticleClinical drug investigation2017

Cost-Effectiveness Analysis of Rivaroxaban for Treatment of Deep Vein Thrombosis and Pulmonary Embolism in Greece.

George Gourzoulidis, Georgia Kourlaba, John Kakisis, Mitiadis Matsagkas, George Giannakoulas, Konstantinos I Gourgoulianis, Theodoros Vassilakopoulos, Nikos Maniadakis

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Clinical drug investigation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 1 country.

George GourzoulidisDepartment of Health Services Organization and Management, National School of Public Health, 196 Alexandras Avenue, 11521, Athens, Greece. gourzoulidis.g@gmail.com.
Georgia KourlabaThe Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
John KakisisDepartment of Vascular Surgery, Attikon Hospital, Athens University Medical School, Athens, Greece.
Mitiadis MatsagkasDepartment of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
George GiannakoulasFirst Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece.
Konstantinos I GourgoulianisDepartment of Respiratory Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
Theodoros VassilakopoulosDepartment of Critical Care and Pulmonary Services, Evangelismos Hospital, University of Athens Medical School, Athens, Greece.
Nikos ManiadakisDepartment of Health Services Organization and Management, National School of Public Health, 196 Alexandras Avenue, 11521, Athens, Greece.
National Public Health Organization · GRAHEPA University Hospital · GREvangelismos Hospital · GRStavros Niarchos Foundation · GRUniversity General Hospital Attikon · GRUniversity of Ioannina · GRUniversity of Thessaly · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveVenous thromboembolism (VTE), comprising deep-vein thrombosis (DVT) and pulmonary embolism (PE), is a major healthcare concern that results in substantial morbidity and mortality with great economic burden for healthcare systems. Hence, the need for effective and efficient treatment of patients with VTE is important for both clinical and economic reasons. The objective of this study was to evaluate the cost effectiveness of rivaroxaban compared to standard of care (SoC) with enoxaparin followed by dose-adjusted vitamin-K antagonists for the treatment of DVT and PE in Greece.

methodsAn existing Markov model was locally adapted from a third-party payer perspective to reflect the management and complications of DVT and PE in the course of 3-month cycles, up to death. The clinical inputs and utility values were extracted from published studies. Direct medical costs, obtained from local resources, were incorporated in the model and refer to year 2017. Both costs and outcomes were discounted at 3.5%. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained was calculated. Probabilistic sensitivity analysis (PSA) was carried out to deal with uncertainty.

resultsThe base-case analysis showed that rivaroxaban in 3- and 6-month treatment duration for DVT and PE, respectively, as this is the common clinical practice in Greece, was associated with a 0.02 and 0.01 increment in QALYs compared to SoC, respectively. Rivaroxaban was associated with a reduced total cost in DVT (€85) but with an additional total cost in PE (€2) compared to SoC. Therefore, rivaroxaban was a dominant (less costly, more effective) and cost-effective (ICER: €177) alternative over SoC for the management of DVT and PE, respectively. PSA revealed that the probability of rivaroxaban being cost effective at a threshold of €34,000 per QALY gained was 99% and 81% for DVT and PE, respectively.

conclusionRivaroxaban may represent a cost-effective option relative to SoC for the management of DVT and PE in Greece.

Indexed as

AgedAnticoagulantsCost-Benefit AnalysisEnoxaparinFibrinolytic AgentsGreeceHumansMiddle AgedPulmonary EmbolismQuality-Adjusted Life YearsRivaroxabanVenous ThrombosisAnticoagulantsEnoxaparinFibrinolytic AgentsRivaroxaban

Identifiers

PMID28608312
OpenAlexW2624900798

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.