Pharmacoeconomic analysis of apixaban use for secondary thromboprophylaxis at outpatient stage among oncological patients


DOI: https://dx.doi.org/10.18565/therapy.2024.1.160-167

Kasimova A.R., Kolbin A.S.

1) Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia; 2) R.R. Vreden National Medical Research Center of Traumatology and Orthopedics of the Ministry of Healthcare of Russia, Saint Petersburg; 3) Saint Petersburg State University
Abstract. Taking into account the need for long-term secondary thromboprophylaxis in patients with cancer incidence, assessing the cost-efficacy of using various therapeutic tactics in such patients is the point of particular interest.
The aim: to make a pharmacoeconomic analysis of validity of Eliquis® (apixaban) medicine use for the secondary prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients with cancer comparatively to other oral anticoagulants’ effect.
Material and methods. The economic assessment was carried out from the perspective of the interests of healthcare of the Russian Federation. The assessment was based on data from previously performed meta-analyses, the results of which were published. Total costs for patient management for each of the compared alternative thromboprophylaxis tactics were determined by calculating the cost of drug therapy, as well as the costs of managing adverse events over 12 months. The conclusion about the most preferable thromboprophylaxis option was made in accordance with obtained data concerning the correlation between efficacy and cost of patient treatment.
Results. During the study, lowest total costs for patient management were fixed when using apixaban: they amounted to 35,082 rubles per year per person. The difference in costs took place mainly due to the cost of treatment with different drugs.
Conclusion. The results of a comparison of effects of apixaban with alternative drugs from the group of direct oral anticoagulants in the prevention of DVT and PE development due to oncologic pathology indicate that the use of this drug may be more valid from the standpoint of economic efficacy, assessed by such a pharmacoeconomic index as direct costs’ minimizing.
Keywords: vascular embolism of the systemic circulation, apixaban, dabigatran etexilate, rivaroxaban, pharmacoeconomic analysis, ischemic stroke, atrial fibrillation
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About the Autors

Alina R. Kasimova, MD, PhD (Medicine), associate professor of the Department of clinical pharmacology and evidence-based medicine, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia, doctor – clinical pharmacologist at the Department of clinical pharmacology, R.R. Vreden National Medical Research Center of Traumatology and Orthopedics of the Ministry of Healthcare of Russia. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo St.
E-mail: kasi-alina@yandex.ru
ORCID: https://orcid.org/0000-0001-6284-7133
Alexey S. Kolbin, MD, Dr. Sci. (Medicine), professor, head of the Department of clinical pharmacology and evidence-based medicine, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia, professor of the Department of pharmacology of the Faculty of medicine, Saint Petersburg State University. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo St.
E-mail: аlex.kolbin@mail.ru
ORCID: https://orcid.org/0000-0002-1919-2909


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