Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Clin Appl Thromb Hemost. 2012 Mar-Apr;18(2):181-4. doi: 10.1177/1076029611416642. Epub 2011 Aug 25.
The aim of our study was to assess hospital budget implications of substituting dabigatran for warfarin in patients enrolled in a large anticoagulation service. The study population was identified using criteria from randomized controlled trials of dabigatran. We obtained labor costs ($483 per patient) from the hospital's anticoagulation service budget, laboratory costs of international normalized ratio (INR) tests ($267 per patient), and wholesale costs of warfarin 5 mg tablets ($31 per patient) and dabigatran 150 mg capsules ($2464 per patient). A total of 1774 (93.5%) of 1898 patients were eligible to substitute dabigatran for warfarin. The annual projected hospital expense for anticoagulation with dabigatran was $4,371,136, attributable to drug cost alone. The annual projected cost of warfarin management was $1,385,494. This was comprised of $856,842 for labor, $473,658 for INR testing, and $54,994 for the drug cost of warfarin. Substitution will result in increased expense due to drug cost.
我们的研究目的是评估在大型抗凝治疗服务中使用达比加群替代华法林对医院预算的影响。研究人群是根据达比加群的随机对照试验的标准确定的。我们从医院抗凝治疗服务预算中获得了劳动力成本（每位患者 483 美元）、国际标准化比值（INR）检测的实验室成本（每位患者 267 美元）以及华法林 5 毫克片剂（每位患者 31 美元）和达比加群 150 毫克胶囊（每位患者 2464 美元）的批发成本。共有 1898 名患者中的 1774 名（93.5%）符合替代达比加群为华法林的条件。使用达比加群抗凝治疗的年度预计医院费用为 437.1136 万美元，仅与药物成本有关。华法林管理的年度预计费用为 138.5494 万美元。这包括劳动力成本 856842 美元、INR 检测成本 473658 美元和华法林药物成本 54994 美元。由于药物成本，替代治疗将导致费用增加。
