Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2019 |
| Outros Autores: | , |
| Tipo de documento: | Artigo |
| Idioma: | por eng |
| Título da fonte: | Revista Brasileira de Cancerologia (Online) |
| Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/295 |
Resumo: | Objective: The study analyzed the cost-effectiveness and budget impact of rivaroxaban versus enoxaparin. Method: This is a retrospective cohort, performed with oncological population from the perspective of the Sistema Único de Saúde (National Health System). The decision tree model compared outcomes of bleeding and retromosis, and costs of treatment of deep venous thrombosis with rivaroxaban or enoxaparin in a time horizon of seven months. Direct costs were extracted from the SIGTAP-SUS, and the Brazilian Spreadsheet for Budgetary Impact of Health Technologies was used to evaluate the Budgetary Impact based in the Brazilian population of 2017 over a five-year period. The sensitivity analysis simulated scenarios for both cost-effectiveness and budget impact assessments. Results: One hundred and fifty-three patients were included in the cost-effectiveness analysis with several neoplasms. Rivaroxaban demonstrated no therapeutic inferiority compared to enoxaparin. The incremental cost-effectiveness ratio was R$ 5,521.71 per benefit unit spared with the new alternative, rivaroxaban. In the sensitivity analysis, rivaroxaban remained dominant. An economy in incremental budget impact of R$ 85,950,791,129.21 was demonstrated with the use of rivaroxaban over five years in comparison to the reference scenario, and this continued as the most economic option in relation to sensitivity analyzes. Conclusion: In this context rivaroxaban was an important therapeutic alternative. |
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Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology PatientsAnálisis de Costo-efectividad e Impacto Presupuestal de Anticoagulantes en el Tratamiento de la Trombosis Venosa Profunda en Pacientes OncológicosAnálise de Custo-efetividade e Impacto Orçamentário de Anticoagulantes no Tratamento da Trombose Venosa Profunda em Pacientes OncológicosFarmacoeconomiaNeoplasiasTrombose VenosaAnticoagulantesSistema Único de SaúdeEconomics, PharmaceuticalNeoplasmsVenous ThrombosisAnticoagulantsUnified Health SystemEconomía FarmacéuticaNeoplasiasTrombosis de la VenaAnticoagulantesSistema Único de SaludObjective: The study analyzed the cost-effectiveness and budget impact of rivaroxaban versus enoxaparin. Method: This is a retrospective cohort, performed with oncological population from the perspective of the Sistema Único de Saúde (National Health System). The decision tree model compared outcomes of bleeding and retromosis, and costs of treatment of deep venous thrombosis with rivaroxaban or enoxaparin in a time horizon of seven months. Direct costs were extracted from the SIGTAP-SUS, and the Brazilian Spreadsheet for Budgetary Impact of Health Technologies was used to evaluate the Budgetary Impact based in the Brazilian population of 2017 over a five-year period. The sensitivity analysis simulated scenarios for both cost-effectiveness and budget impact assessments. Results: One hundred and fifty-three patients were included in the cost-effectiveness analysis with several neoplasms. Rivaroxaban demonstrated no therapeutic inferiority compared to enoxaparin. The incremental cost-effectiveness ratio was R$ 5,521.71 per benefit unit spared with the new alternative, rivaroxaban. In the sensitivity analysis, rivaroxaban remained dominant. An economy in incremental budget impact of R$ 85,950,791,129.21 was demonstrated with the use of rivaroxaban over five years in comparison to the reference scenario, and this continued as the most economic option in relation to sensitivity analyzes. Conclusion: In this context rivaroxaban was an important therapeutic alternative.Introducción: La trombosis venosa profunda es una complicación común e íntimamente relacionada a las neoplasias. Los nuevos anticoagulantes orales fueron lanzados en los últimos años, entre ellos la rivaroxabana. Objetivo: El estudio analizó el Costo-Efectividad y el Impacto Presupuestario de la rivaroxabana versus enoxaparina. Método: En el modelo de árbol de decisión se compararon los resultados de la hemorragia y la retrombosis, y los costos del tratamiento de la trombosis venosa profunda con rivaroxabana o enoxaparina, con una cohorte retrospectiva, realizada con población oncológica bajo la perspectiva del Sistema Único de Salud en un horizonte temporal de siete meses. Los costos directos fueron extraídos del SIGTAP-SUS, y se empleó la Planilla Brasileña de Impacto Presupuestario de Tecnologías de la Salud para evaluación del Impacto Presupuestario con base en la población brasileña de 2017 en un horizonte temporal de cinco años. El análisis de sensibilidad simuló escenarios tanto en la evaluación de Costo-Efectividad y en la de Impacto Presupuestario. Resultados: Ciento cincuenta y tres pacientes fueron incluidos en el análisis de Costo-Efectividad con diversas neoplasias. La rivaroxabana demostró no inferioridad terapéutica comparada a la enoxaparina. La razón de costo-efectividad incremental fue de R $ 5.521,71 por unidad de beneficio ganada con la nueva alternativa, rivaroxabana. En el análisis de sensibilidad, la rivaroxabana se mantuvo dominante. Se demostró una economía em el Impacto Presupuestario incremental de R $ 85.950.791.129,21 con la utilización de rivaroxabana a lo largo de 5 años en comparación al escenario de referencia, y ésta se mantuvo como opción más económica ante los análisis de sensibilidad. Conclusión: La rivaroxabana, en este contexto, se presentó como una importante alternativa terapéutica.Introdução: A trombose venosa profunda é uma complicação comum e intimamente relacionada às neoplasias. Novos anticoagulantes orais foram lançados nos últimos anos, entre eles a rivaroxabana. Objetivo: O estudo analisou o Custo-Efetividade e o Impacto Orçamentário da rivaroxabana versus enoxaparina. Método: Trata-se de uma coorte retrospectiva, realizada com população oncológica sob a perspectiva do Sistema Único de Saúde. Por meio do modelo de árvore de decisão foram comparados desfechos de sangramento e retrombose, e custos do tratamento da trombose venosa profunda com rivaroxabana ou enoxaparina em um horizonte temporal de sete meses. Custos diretos foram extraídos do Sistema de Gerenciamento da Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais e Medicamentos Especiais do SUS (SIGTAP-SUS), e empregou-se a Planilha Brasileira de Impacto Orçamentário de tecnologias da saúde para avaliação do impacto orçamentário com base na população brasileira de 2017, em cinco anos. A análise de sensibilidade simulou cenários tanto na avaliação de custo-efetividade quanto na de impacto orçamentário. Resultados: Cento e cinquenta e três pacientes foram incluídos na análise de Custo-Efetividade com diversas neoplasias. A rivaroxabana demonstrou não inferioridade terapêutica comparada a enoxaparina. A razão de custo-efetividade incremental foi de R$5.521,71 por unidade de benefício ganho com a nova alternativa, rivaroxabana. Na análise de sensibilidade, a rivaroxabana manteve-se dominante. Foi demonstrada uma economia no impacto orçamentário incremental de R$ 85.950.791.129,21 com a utilização de rivaroxabana ao longo de cinco anos em comparação ao cenário de referência, e esta se manteve como opção mais econômica perante as análises de sensibilidade. Conclusão: A rivaroxabana, nesse contexto, apresentou-se como uma importante alternativa terapêutica.INCA2019-09-19info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtigos, Avaliado pelos paresapplication/pdfapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/29510.32635/2176-9745.RBC.2019v65n3.295Revista Brasileira de Cancerologia; Vol. 65 No. 3 (2019): July/Aug./Sept.; e-01295Revista Brasileira de Cancerologia; Vol. 65 Núm. 3 (2019): jul./agosto/sept.; e-01295Revista Brasileira de Cancerologia; v. 65 n. 3 (2019): jul./ago./set.; e-012952176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporenghttps://rbc.inca.gov.br/index.php/revista/article/view/295/292https://rbc.inca.gov.br/index.php/revista/article/view/295/602Copyright (c) 2019 Revista Brasileira de Cancerologiainfo:eu-repo/semantics/openAccessSampaio, Thamiris Brandão Peixoto Renni, Marcos Jose Pereira Costa, Rodrigo Saar da2021-11-29T20:03:54Zoai:rbc.inca.gov.br:article/295Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2021-11-29T20:03:54Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
| dc.title.none.fl_str_mv |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients Análisis de Costo-efectividad e Impacto Presupuestal de Anticoagulantes en el Tratamiento de la Trombosis Venosa Profunda en Pacientes Oncológicos Análise de Custo-efetividade e Impacto Orçamentário de Anticoagulantes no Tratamento da Trombose Venosa Profunda em Pacientes Oncológicos |
| title |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| spellingShingle |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients Sampaio, Thamiris Brandão Peixoto Farmacoeconomia Neoplasias Trombose Venosa Anticoagulantes Sistema Único de Saúde Economics, Pharmaceutical Neoplasms Venous Thrombosis Anticoagulants Unified Health System Economía Farmacéutica Neoplasias Trombosis de la Vena Anticoagulantes Sistema Único de Salud |
| title_short |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| title_full |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| title_fullStr |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| title_full_unstemmed |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| title_sort |
Analysis of Cost-effectiveness and Budget Impact of Anticoagulants in the Treatment of Deep Venous Thrombosis in Oncology Patients |
| author |
Sampaio, Thamiris Brandão Peixoto |
| author_facet |
Sampaio, Thamiris Brandão Peixoto Renni, Marcos Jose Pereira Costa, Rodrigo Saar da |
| author_role |
author |
| author2 |
Renni, Marcos Jose Pereira Costa, Rodrigo Saar da |
| author2_role |
author author |
| dc.contributor.author.fl_str_mv |
Sampaio, Thamiris Brandão Peixoto Renni, Marcos Jose Pereira Costa, Rodrigo Saar da |
| dc.subject.por.fl_str_mv |
Farmacoeconomia Neoplasias Trombose Venosa Anticoagulantes Sistema Único de Saúde Economics, Pharmaceutical Neoplasms Venous Thrombosis Anticoagulants Unified Health System Economía Farmacéutica Neoplasias Trombosis de la Vena Anticoagulantes Sistema Único de Salud |
| topic |
Farmacoeconomia Neoplasias Trombose Venosa Anticoagulantes Sistema Único de Saúde Economics, Pharmaceutical Neoplasms Venous Thrombosis Anticoagulants Unified Health System Economía Farmacéutica Neoplasias Trombosis de la Vena Anticoagulantes Sistema Único de Salud |
| description |
Objective: The study analyzed the cost-effectiveness and budget impact of rivaroxaban versus enoxaparin. Method: This is a retrospective cohort, performed with oncological population from the perspective of the Sistema Único de Saúde (National Health System). The decision tree model compared outcomes of bleeding and retromosis, and costs of treatment of deep venous thrombosis with rivaroxaban or enoxaparin in a time horizon of seven months. Direct costs were extracted from the SIGTAP-SUS, and the Brazilian Spreadsheet for Budgetary Impact of Health Technologies was used to evaluate the Budgetary Impact based in the Brazilian population of 2017 over a five-year period. The sensitivity analysis simulated scenarios for both cost-effectiveness and budget impact assessments. Results: One hundred and fifty-three patients were included in the cost-effectiveness analysis with several neoplasms. Rivaroxaban demonstrated no therapeutic inferiority compared to enoxaparin. The incremental cost-effectiveness ratio was R$ 5,521.71 per benefit unit spared with the new alternative, rivaroxaban. In the sensitivity analysis, rivaroxaban remained dominant. An economy in incremental budget impact of R$ 85,950,791,129.21 was demonstrated with the use of rivaroxaban over five years in comparison to the reference scenario, and this continued as the most economic option in relation to sensitivity analyzes. Conclusion: In this context rivaroxaban was an important therapeutic alternative. |
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2019 |
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2019-09-19 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Artigos, Avaliado pelos pares |
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https://rbc.inca.gov.br/index.php/revista/article/view/295 10.32635/2176-9745.RBC.2019v65n3.295 |
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https://rbc.inca.gov.br/index.php/revista/article/view/295 |
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https://rbc.inca.gov.br/index.php/revista/article/view/295/292 https://rbc.inca.gov.br/index.php/revista/article/view/295/602 |
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Copyright (c) 2019 Revista Brasileira de Cancerologia |
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openAccess |
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application/pdf application/pdf |
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Revista Brasileira de Cancerologia; Vol. 65 No. 3 (2019): July/Aug./Sept.; e-01295 Revista Brasileira de Cancerologia; Vol. 65 Núm. 3 (2019): jul./agosto/sept.; e-01295 Revista Brasileira de Cancerologia; v. 65 n. 3 (2019): jul./ago./set.; e-01295 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
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