Publication

Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects

De Jong, L. A., Gout-Zwart, J. J., Stevanovic, J., Rila, H., Koops, M., Huisman, M. V. & Postma, M. J., 30-Dec-2018, In : BMJ Open. 2, 3, p. e315-e324 10 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

De Jong, L. A., Gout-Zwart, J. J., Stevanovic, J., Rila, H., Koops, M., Huisman, M. V., & Postma, M. J. (2018). Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects. BMJ Open, 2(3), e315-e324. https://doi.org/10.1055/s-0038-1672185

Author

De Jong, Lisa A. ; Gout-Zwart, Judith J. ; Stevanovic, Jelena ; Rila, Harrie ; Koops, Mike ; Huisman, Menno V. ; Postma, Maarten J. / Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands : Clinical and Economic Effects. In: BMJ Open. 2018 ; Vol. 2, No. 3. pp. e315-e324.

Harvard

De Jong, LA, Gout-Zwart, JJ, Stevanovic, J, Rila, H, Koops, M, Huisman, MV & Postma, MJ 2018, 'Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects' BMJ Open, vol. 2, no. 3, pp. e315-e324. https://doi.org/10.1055/s-0038-1672185

Standard

Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands : Clinical and Economic Effects. / De Jong, Lisa A.; Gout-Zwart, Judith J.; Stevanovic, Jelena; Rila, Harrie; Koops, Mike; Huisman, Menno V.; Postma, Maarten J.

In: BMJ Open, Vol. 2, No. 3, 30.12.2018, p. e315-e324.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

De Jong LA, Gout-Zwart JJ, Stevanovic J, Rila H, Koops M, Huisman MV et al. Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects. BMJ Open. 2018 Dec 30;2(3):e315-e324. https://doi.org/10.1055/s-0038-1672185


BibTeX

@article{798ecb6811a94614bcaa286d6454007e,
title = "Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands: Clinical and Economic Effects",
abstract = "Background ?Dutch guidelines advise extended anticoagulant treatment with direct oral anticoagulants or vitamin K antagonists for patients with idiopathic venous thromboembolism (VTE) who do not have high bleeding risk. Objectives ?The aim of this study was to analyze the economic effects of extended treatment of apixaban in the Netherlands, based on an updated and adapted previously published model. Methods ?We performed a cost-effectiveness analysis simulating a population of 1,000 VTE patients. The base-case analysis compared extended apixaban treatment to no treatment after the first 6 months. Five additional scenarios were conducted to evaluate the effect of different bleeding risks and health care payers' perspective. The primary outcome of the model is the incremental cost-effectiveness ratio (ICER) in costs (€) per quality-adjusted life-year (QALY), with one QALY defined as 1 year in perfect health. To account for any influence of the uncertainties in the model, probabilistic and univariate sensitivity analyses were conducted. The treatment was considered cost-effective with an ICER less than €20,000/QALY, which is the most commonly used willingness-to-pay (WTP) threshold for preventive drugs in the Netherlands. Results ?The model showed a reduction in recurrent VTE and no increase in major bleeding events for extended treatment in all scenarios. The base-case analysis showed an ICER of €9,653/QALY. The probability of being cost-effective for apixaban in the base-case was 70.0{\%} and 91.4{\%} at a WTP threshold of €20,000/QALY and €50,000/QALY, respectively. Conclusion ?Extended treatment with apixaban is cost-effective for the prevention of recurrent VTE in Dutch patients.",
keywords = "apixaban, cost-effectiveness, lifelong treatment, non-vitamin K oral anticoagulants, venous thrombosis, acenocoumarol, low molecular weight heparin, phenprocoumon, adult, aged, anticoagulant therapy, article, clinical outcome, controlled clinical trial (topic), controlled study, cost effectiveness analysis, drug cost, embolism prevention, female, human, major clinical study, male, Netherlands, priority journal, quality adjusted life year, thrombosis prevention, venous thromboembolism",
author = "{De Jong}, {Lisa A.} and Gout-Zwart, {Judith J.} and Jelena Stevanovic and Harrie Rila and Mike Koops and Huisman, {Menno V.} and Postma, {Maarten J.}",
year = "2018",
month = "12",
day = "30",
doi = "10.1055/s-0038-1672185",
language = "English",
volume = "2",
pages = "e315--e324",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ PUBLISHING GROUP",
number = "3",

}

RIS

TY - JOUR

T1 - Extended Treatment with Apixaban for Venous Thromboembolism Prevention in the Netherlands

T2 - Clinical and Economic Effects

AU - De Jong, Lisa A.

AU - Gout-Zwart, Judith J.

AU - Stevanovic, Jelena

AU - Rila, Harrie

AU - Koops, Mike

AU - Huisman, Menno V.

AU - Postma, Maarten J.

PY - 2018/12/30

Y1 - 2018/12/30

N2 - Background ?Dutch guidelines advise extended anticoagulant treatment with direct oral anticoagulants or vitamin K antagonists for patients with idiopathic venous thromboembolism (VTE) who do not have high bleeding risk. Objectives ?The aim of this study was to analyze the economic effects of extended treatment of apixaban in the Netherlands, based on an updated and adapted previously published model. Methods ?We performed a cost-effectiveness analysis simulating a population of 1,000 VTE patients. The base-case analysis compared extended apixaban treatment to no treatment after the first 6 months. Five additional scenarios were conducted to evaluate the effect of different bleeding risks and health care payers' perspective. The primary outcome of the model is the incremental cost-effectiveness ratio (ICER) in costs (€) per quality-adjusted life-year (QALY), with one QALY defined as 1 year in perfect health. To account for any influence of the uncertainties in the model, probabilistic and univariate sensitivity analyses were conducted. The treatment was considered cost-effective with an ICER less than €20,000/QALY, which is the most commonly used willingness-to-pay (WTP) threshold for preventive drugs in the Netherlands. Results ?The model showed a reduction in recurrent VTE and no increase in major bleeding events for extended treatment in all scenarios. The base-case analysis showed an ICER of €9,653/QALY. The probability of being cost-effective for apixaban in the base-case was 70.0% and 91.4% at a WTP threshold of €20,000/QALY and €50,000/QALY, respectively. Conclusion ?Extended treatment with apixaban is cost-effective for the prevention of recurrent VTE in Dutch patients.

AB - Background ?Dutch guidelines advise extended anticoagulant treatment with direct oral anticoagulants or vitamin K antagonists for patients with idiopathic venous thromboembolism (VTE) who do not have high bleeding risk. Objectives ?The aim of this study was to analyze the economic effects of extended treatment of apixaban in the Netherlands, based on an updated and adapted previously published model. Methods ?We performed a cost-effectiveness analysis simulating a population of 1,000 VTE patients. The base-case analysis compared extended apixaban treatment to no treatment after the first 6 months. Five additional scenarios were conducted to evaluate the effect of different bleeding risks and health care payers' perspective. The primary outcome of the model is the incremental cost-effectiveness ratio (ICER) in costs (€) per quality-adjusted life-year (QALY), with one QALY defined as 1 year in perfect health. To account for any influence of the uncertainties in the model, probabilistic and univariate sensitivity analyses were conducted. The treatment was considered cost-effective with an ICER less than €20,000/QALY, which is the most commonly used willingness-to-pay (WTP) threshold for preventive drugs in the Netherlands. Results ?The model showed a reduction in recurrent VTE and no increase in major bleeding events for extended treatment in all scenarios. The base-case analysis showed an ICER of €9,653/QALY. The probability of being cost-effective for apixaban in the base-case was 70.0% and 91.4% at a WTP threshold of €20,000/QALY and €50,000/QALY, respectively. Conclusion ?Extended treatment with apixaban is cost-effective for the prevention of recurrent VTE in Dutch patients.

KW - apixaban

KW - cost-effectiveness

KW - lifelong treatment

KW - non-vitamin K oral anticoagulants

KW - venous thrombosis

KW - acenocoumarol

KW - low molecular weight heparin

KW - phenprocoumon

KW - adult

KW - aged

KW - anticoagulant therapy

KW - article

KW - clinical outcome

KW - controlled clinical trial (topic)

KW - controlled study

KW - cost effectiveness analysis

KW - drug cost

KW - embolism prevention

KW - female

KW - human

KW - major clinical study

KW - male

KW - Netherlands

KW - priority journal

KW - quality adjusted life year

KW - thrombosis prevention

KW - venous thromboembolism

U2 - 10.1055/s-0038-1672185

DO - 10.1055/s-0038-1672185

M3 - Article

VL - 2

SP - e315-e324

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 3

ER -

ID: 72582251