Caro J Jaime, Getsios Denis, Caro Ingrid, O'Brien Judith A
Caro Research Institute, Concord, Massachusetts 01742, USA.
Pharmacoeconomics. 2002;20(9):593-602. doi: 10.2165/00019053-200220090-00003.
To evaluate economic and health implications of tinzaparin sodium, a once a day low-molecular-weight heparin (LMWH), versus unfractionated heparin (UFH) in the treatment of acute deep vein thrombosis (DVT) from a US healthcare payer perspective.
An economic model, composed of two submodules, was created: A short-term module based on clinical trial data covering the first 3 months and a long-term module that projects trial results based on published data for up to 50 years.
Clinical trial results were combined with data from long-term follow-up studies of DVT in a model that estimates the health and economic consequences of treatment. Both short- and long-term costs with tinzaparin sodium were compared with UFH, as were health outcomes and quality-adjusted life-years (QALYs).
Patients treated with tinzaparin sodium are estimated to live a mean of 0.9 years longer on average (0.6 discounted), resulting in an increase of 0.8 QALYs (0.5 discounted). At the same time, lifetime savings are US dollars 621 per patient (1999 values), even when all patients receiving tinzapirin sodium are treated as inpatients. Early discharge of patients receiving tinzaparin sodium, or outpatient treatment, would save between US dollars 3000 and US dollars 5000 per patient.
Tinzaparin sodium leads to better health outcomes and substantial economic savings compared with UFH treatment when all management costs are considered.
从美国医疗保健支付方的角度,评估每日一次的低分子量肝素(LMWH)替扎肝素钠与普通肝素(UFH)在治疗急性深静脉血栓形成(DVT)方面的经济和健康影响。
创建了一个由两个子模块组成的经济模型:一个基于涵盖前3个月的临床试验数据的短期模块,以及一个基于已发表数据预测长达50年试验结果的长期模块。
将临床试验结果与DVT长期随访研究的数据相结合,建立一个模型来估计治疗的健康和经济后果。将替扎肝素钠的短期和长期成本与UFH的成本进行比较,同时比较健康结局和质量调整生命年(QALY)。
估计接受替扎肝素钠治疗的患者平均寿命延长0.9年(贴现后为0.6年),导致QALY增加0.8(贴现后为0.5)。同时,即使将所有接受替扎肝素钠治疗的患者视为住院患者,每位患者一生可节省621美元(1999年价值)。接受替扎肝素钠治疗的患者提前出院或门诊治疗,每位患者可节省3000至5000美元。
当考虑所有管理成本时,与UFH治疗相比,替扎肝素钠可带来更好的健康结局和可观的经济节省。