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Title: The analysis of effectiveness and costs of using low-molecular-weight heparins in comparison with oral anticoagulants for the treatment of venous thromboembolism

Author:

Bochenek, Tomasz

Date:

2011

Type:

Praca doktorska

Abstract:

OBJECTIVE: The currently recommended standard treatment of venous thromboembolism (VTE) are oral anticoagulants (OA) in majority of patients and low-molecular-weight heparins (LMWH) in selected subpopulations. The titration of OA doses is difficult and often ineffective. The goal of this research was to compare LMWH and OA in VTE treatment, in terms of effectiveness, safety and cost-effectiveness. METHODS: The systematic review of scientific literature and the metaanalysis of reported treatment outcomes were performed. The cost analysis and the cost-effectiveness analysis were performed. The data on costs of treatment were collected through the retrospective review of patient records obtained from three hospitals and anticoagulation clinic, pharmaceutical reimbursement databases and public payer’s charge tariffs for medical services. The modeling (decision tree) was performed. RESULTS: The most important differences between LMWH and OA, in favor of LMWH, were related to better prevention of VTE incidence and better prevention of small bleedings. With respect to none of assessed outcomes OA were better than LMWH. Within a six month treatment period the ICER ratio of avoiding the complication incidents was 49.865 zlotys (12.242 EURO) from payer perspective and 3.609 zlotys (887 EUR) from patient perspective. CONCLUSION: LMWH offer better effectiveness and safety than OA but the treatment is associated with considerably higher costs. Medical considerations support more general use of LMWH in VTE treatment but the economic constraints are essential barrier in dissemination of this method of treatment.

Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia

Degree grantor:

Wydział Lekarski

Promoter:

Rafał Niżankowski

Date issued:

2010

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:837

Call number:

ZB-113854

ControlNumberVIRTUA:

click here to follow the link

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

Subject and keywords:

venous thromboembolism deep vein thrombosis pulmonary embolism cost-effectiveness analysis

Object collections:

Last modified:

Oct 15, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

11

Number of object content views in PDF format

10

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/837

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Edition name Date
ZB-113854 Oct 15, 2019

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