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A comparative cost-effectiveness analysis of mechanical and pharmacological VTE prophylaxis after lower limb arthroplasty in Australia

Journal of Orthopaedic Surgery and Research Apr 09, 2019

Torres RT, et al. - In this study, authors examined the cost and quality-adjusted life years (QALYs) saved of commonly used venous thromboembolism (VTE) prophylaxis regimens following lower limb arthroplasty. They observed a range of costs from AUD $644 (IPC) to AUD $956 (rivaroxaban) for VTE prophylaxis including treatment of its correlated complications over the first year after surgery. Intermittent pneumatic compression (IPC) was the cheapest measure in 73% of simulations across 500 simulations. An association of DOAC with the highest resulting QALYs was observed in 97% of simulations. They found apixaban cost-effective in 76.4% of simulations and apixaban plus IPC in 87.8% of simulations when compared to IPC. They overall suggested apixaban, IPC or a sequential/simultaneous combination of both the most cost-effective VTE prophylaxis regimens. They also suggested choosing the regimen by the relative VTE and bleeding risks of an individual case.
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