Lundkvist Jonas, Bergqvist David, Jönsson Bengt
European Health Economics, Vasagatan 38, Stockholm, Sweden.
Eur J Health Econ. 2007 Dec;8(4):313-23. doi: 10.1007/s10198-006-0017-2. Epub 2007 Jan 16.
A model was developed to estimate costs and clinical effectiveness of fondaparinux compared with enoxaparin after hip fracture surgery in Sweden. Outcomes and costs of venous thromboembolism (VTE)-related care from a health care perspective were incorporated, with symptomatic deep-vein thrombosis and pulmonary embolism, recurrent VTE, post-thrombotic syndrome, major haemorrhage and all-cause death being included. Event probabilities were derived from fondaparinux clinical trial data and published data. VTE-related resource use and associated costs as well as costs of prophylaxis were based on local Swedish data. Extended prophylaxis with fondaparinux could avoid an additional 28 symptomatic VTE per 1,000 patients compared with extended prophylaxis with enoxaparin in hip fracture surgery patients. Although the prophylaxis costs were higher in the fondaparinux group, these were offset by the lower costs associated with treating fewer VTE, which thus indicates that extended fondaparinux prophylaxis is the dominant alternative when compared with enoxaparin in hip fracture surgery.
研究建立了一个模型，用于评估在瑞典髋部骨折手术后，磺达肝癸钠与依诺肝素相比的成本及临床效果。从医疗保健角度纳入了静脉血栓栓塞（VTE）相关护理的结果和成本，包括症状性深静脉血栓形成和肺栓塞、复发性VTE、血栓后综合征、大出血和全因死亡。事件概率来自磺达肝癸钠临床试验数据和已发表的数据。VTE相关资源使用及相关成本以及预防成本基于瑞典当地数据。与髋部骨折手术患者使用依诺肝素进行延长预防相比，使用磺达肝癸钠进行延长预防每1000名患者可额外避免28例症状性VTE。尽管磺达肝癸钠组的预防成本较高，但因治疗较少VTE相关的较低成本而得到抵消，这表明在髋部骨折手术中，与依诺肝素相比，延长使用磺达肝癸钠预防是更具优势的选择。
