Cost-Effectiveness of Rivaroxaban for Prevention of Deep Vein Thrombosis and Pulmonary Embolism after Total Hip or Knee Replacement in US Patients

and clinical experience of VTE in the US u Probabilistic sensitivity analysis (PSA) was performed to assess variations of treatment costs and significant and non-significant trial endpoints (including symptomatic events and major bleeding) and its impact on cost-effectiveness - PSA addresses the uncertainty around all observed variables (efficacy, safety from clinical trials, cost variables from published literature) used in the economic model and several simulations ran simultaneously using different values within the 95% confidence interval or a predefined range for treatment cost u The duration of prophylaxis with rivaroxaban was assumed to be 35 days for THR patients and 14 days for TKR patients. As rivaroxaban is not yet available in the US, the analysis assumed similar daily drug acquisition costs to enoxaparin 40 mg once daily in the US u RECORD2 showed that long-term prophylaxis with rivaroxaban was associated with an incremental cost per symptomatic venous thromboembolic event avoided of $5,945 (Table 2) u Similar analysis based on RECORD3 demonstrated that rivaroxaban resulted in an average cost saving of $285 and a reduction of 18 symptomatic events, both per 1,000 patients undergoing TKR (Table 2) u RECORD4 versus enoxaparin (North American regimen of 30 mg q12h) demonstrated that rivaroxaban was associated with an average cost saving of $291 and a reduction of 1.6 events, both per 1,000 patients undergoing TKR (Table 2) - These improvements were driven primarily by the reduced costs of