US hospitals using rivaroxaban (Xarelto, Janssen Pharmaceuticals) instead of warfarin (Coumadin, Bristol-Myers Squibb) to treat patients diagnosed with a venous thromboembolism (VTE) may save nearly $2,000 per patient and shorten a patient’s hospital stay by approximately 1.5 days, according to a new study.
The economic analysis, presented earlier this month at Hospital Medicine 2016, compared the cost savings associated with treatment with Xarelto, a non-vitamin K antagonist oral anticoagulant (NOAC), to warfarin in hospitals.
"Venous thromboembolism, or VTE, represents a tremendous burden to our healthcare system, as the cost of treating these blood clots remains so high," said Steven Deitelzweig, MD, system chairman of hospital medicine and medical director of regional business development at the Ochsner Clinic Foundation in New Orleans, La.
VTE affects more than 900,000 Americans each year and one-third of the episodes will be fatal, according to Janssen. Published research in Thrombosis & Haemostasis shows VTEs cost the US healthcare system between $13.5 and $27.2 billion a year.
The study evaluated 2,446 people who were admitted to the hospital following a primary VTE diagnosis and were treated with either Xarelto or warfarin. Patients were identified from the Truven MarketScan Hospital Drug Database between November, 2012, and December, 2013. Each group included 1,223 patients (751 PE patients and 472 DVT patients), who were an average of 64 years old.
Researchers found total hospitalization costs were significantly lower and length of stay was significantly shorter for people taking Xarelto compared to those receiving warfarin. Patients taking Xarelto stayed at the hospital an average of 1.57 fewer days (3.7±3.1 days vs. 5.2±3.7 days).
In the study, researchers also examined how the use of parenteral anticoagulants, including low-molecular-weight heparin (LMWH) or unfractionated heparin, impacted length of stay. These anticoagulants were administered intravenously or via infusion to approximately 64% of patients in each group.
The number of hospital days from first dose to discharge was lower for the Xarelto group, when initiated with or without parenteral anticoagulants, compared to the warfarin group.
"Beyond our economic research, physicians can feel confident prescribing Xarelto for their patients with DVT or PE based on the proven safety and efficacy profile as observed in the EINSTEIN trials and pooled analysis, which confirmed Xarelto has similar efficacy and reduced the incidence of major bleeding by nearly half compared to enoxaparin, a low-molecular-weight heparin, and warfarin,” said Paul Burton, MD, vice president of Medical Affairs for Janssen.