Williams House, Manchester University Science Park, Lloyd Street North, Manchester M15 6SE, UK.
Thromb Haemost. 2010 Feb;103(2):360-71. doi: 10.1160/TH09-08-0579. Epub 2009 Dec 18.
Oral dabigatran etexilate is indicated for the prevention of venous thromboembolism (VTE) in patients undergoing total knee replacement or total hip replacement. We investigated the cost-effectiveness of the 150 mg once daily (od) dose recommended for patients aged over 75 or with moderate renal impairment, from a United Kingdom National Health Service perspective. Dabigatran etexilate was compared with subcutaneous enoxaparin 40 mg od, using a decision model. Risks for VTE and bleeding were derived from subgroup analyses of the phase III trials. Dabigatran etexilate was less costly than enoxaparin; cost savings varied from pound62 to pound274 (base-case analyses) and were primarily due to differences in administration costs. Results were robust across a range of sensitivity analyses. Dabigatran etexilate 150 mg od is cost saving compared with enoxaparin 40 mg od in patients aged over 75years and in patients with moderate renal impairment, with comparable efficacy and safety.
口服达比加群酯用于预防全膝关节置换或全髋关节置换患者的静脉血栓栓塞（VTE）。我们从英国国家医疗服务体系的角度调查了推荐用于 75 岁以上或中度肾功能损害患者的 150mg 每日一次（od）剂量的成本效益。达比加群酯与皮下依诺肝素 40mg od 进行比较，使用决策模型。VTE 和出血风险来自 III 期试验的亚组分析。达比加群酯比依诺肝素更具成本效益；节省的成本从 62 英镑到 274 英镑不等（基础案例分析），主要是由于给药成本的差异。结果在一系列敏感性分析中具有稳健性。达比加群酯 150mg od 在 75 岁以上患者和中度肾功能损害患者中与依诺肝素 40mg od 相比具有成本效益，具有相当的疗效和安全性。
