Monday, February 10, 2025

Saudi Health Study Endorses Apixaban Over Rivaroxaban for VTE Treatment

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A recent retrospective analysis spanning five years in Saudi Arabia demonstrates that apixaban surpasses rivaroxaban in preventing venous thromboembolism (VTE) recurrences and related complications, although it incurs higher direct medical costs.

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Methodology and Data Analysis

Conducted across three tertiary care hospitals from January 2016 to December 2020, the study examined 367 VTE patients, with 176 receiving apixaban and 191 on rivaroxaban. Effectiveness was assessed by the reduction in VTE recurrence, major bleeding, or clinically relevant non-major bleeding within 90 days post-treatment, alongside rehospitalizations due to these issues. The economic evaluation focused exclusively on direct medical costs from the Saudi National Health System’s perspective, utilizing the bootstrapping method to determine the 95% confidence intervals for both costs and effectiveness rates.

Key Findings

– Apixaban demonstrated a 91% effectiveness rate, significantly higher than rivaroxaban’s 77%
– The annual medication cost for apixaban stood at $547.05, compared to $577.77 for rivaroxaban
– Direct medical expenses averaged $6,496.83 for apixaban users versus $5,528.58 for those on rivaroxaban
– In 94.81% of bootstrap distributions, apixaban was more effective but also costlier, while in 5.19%, it was both more effective and less expensive

The incremental cost-effectiveness ratio (ICER) for apixaban was calculated at $6,916.07, indicating the additional cost required to prevent one composite outcome compared to rivaroxaban.

These results highlight that apixaban offers considerable clinical benefits in managing VTE, reducing the likelihood of recurrence and severe bleeding events more effectively than rivaroxaban. However, these advantages come with increased direct medical costs, posing challenges for healthcare budgeting and resource allocation.

Healthcare providers must weigh the enhanced effectiveness of apixaban against its higher costs, considering factors such as patient risk profiles, long-term outcomes, and overall healthcare expenditure to make informed anticoagulant therapy decisions.

Policymakers should integrate these findings into national formularies and treatment guidelines, ensuring that the selection of anticoagulants aligns with both clinical efficacy and economic sustainability to optimize patient care and resource utilization.

Understanding the nuanced balance between cost and effectiveness is crucial for advancing VTE treatment strategies in Saudi Arabia, ultimately aiming to enhance patient outcomes while maintaining financial viability within the healthcare system.

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