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- W2810237727 abstract "Low-molecular-weight heparin is the guideline-recommended therapy for cancer-associated venous thromboembolism (VTE). Even though treatment of cancer-associated VTE is difficult, edoxaban and dalteparin have been examined to address such challenge. The Hokusai VTE-cancer trial showed that oral edoxaban was noninferior to treatment with subcutaneous dalteparin with respect to the composite outcome of recurrent VTE or major bleeding. The objective of this study was to evaluate the cost-effectiveness of edoxaban versus dalteparin for the treatment of cancer-associated VTE. A Markov cohort model was developed from a US payer perspective. We evaluated the total costs, quality adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) associated with edoxaban and dalteparin in cancer patients treated for deep vein thrombosis and pulmonary embolism. Transition probabilities were calculated based on the Hokusai VTE-cancer study and published literature. Utilities and costs were obtained from published literature. A 5-year time horizon with 6-month cycle length and a 3% annual discount rate were used. All costs were adjusted to 2017 US dollars. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the model to changes in key parameters. Compared with edoxaban, dalteparin was associated with a gain of 0.16 QALYs, and additional $1,772 costs, yielding the ICER of $10,964 per QALY gained. Based on one-way sensitivity analysis, the results were sensitive to the discontinuation rates, the mortality rate of dalteparin, and the drug price of dalteparin. Probabilistic sensitivity analysis showed that dalteparin had an 88.6% probability of being cost-effective at a willingness-to-pay of $50,000 per QALY. Although subcutaneous dalteparin is burdensome compared with oral edoxaban, dalteparin is a cost-effective option for treatment of cancer-associated VTE." @default.
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- W2810237727 date "2018-05-01" @default.
- W2810237727 modified "2023-10-18" @default.
- W2810237727 title "Cost-Effectiveness of Edoxaban Compared with Dalteparin for the Treatment of Cancer-Associated Venous Thromboembolism" @default.
- W2810237727 doi "https://doi.org/10.1016/j.jval.2018.04.1463" @default.
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