| Title |
Dalteparin versus vitamin K antagonists for the prevention of recurrent venous thromboembolism in patients with cancer and renal impairment: a Canadian pharmacoeconomic analysis
|
|---|---|
| Published in |
ClinicoEconomics and Outcomes Research: CEOR, January 2017
|
| DOI | 10.2147/ceor.s126379 |
| Pubmed ID | |
| Authors |
George Dranitsaris, Lesley G Shane, Mark Crowther, Guillaume Feugere, Seth Woodruff |
| Abstract |
Patients with cancer are at increased risk of venous thromboembolism (VTE) and the risk is further elevated after a primary VTE. To reduce the risk of recurrent events, extended prophylaxis with vitamin K antagonists (VKA) is available for use. However, in a large randomized trial (Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer [CLOT]; Lee et al), extended duration dalteparin reduced the relative risk of recurrent VTE by 52% compared to VKA (p=0.002). A recent subgroup analysis of patients with moderate-to-severe renal impairment also revealed lower absolute VTE rates with dalteparin (3% vs. 17%; p=0.011). To measure the economic value of dalteparin as an alternative to VKA, a patient-level cost utility analysis was conducted from a Canadian perspective. Resource use data captured during the CLOT trial were extracted and linked to 2015 Canadian unit cost estimates. Health state utilities were then measured using the Time-Trade-Off technique in 24 randomly selected members of the general Canadian public to estimate the gains in quality-adjusted life years (QALYs). For the entire CLOT trial population (n=676), the dalteparin group had significantly higher mean costs compared to the VKA group ($Can5,771 vs. $Can2,569; p<0.001). However, the utility assessment revealed that 21 of 24 respondents (88%) selected dalteparin over VKA, with an associated gain of 0.14 (95% confidence interval [CI]: 0.10-0.18) QALYs. When the incremental cost of dalteparin was combined with the QALY gain, dalteparin had a cost of $Can23,100 (95% CI: $Can19,200-$Can25,800) per QALY gained. The analysis in patients with renal impairment suggested even better economic value with the cost per QALY gained being <$14,000. Extended duration dalteparin is a cost-effective alternative to VKA for the prevention of recurrent VTE in patients with cancer, especially in those with renal impairment. |
Mendeley readers
The data shown below were compiled from readership statistics for 26 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 26 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 6 | 23% |
| Student > Bachelor | 5 | 19% |
| Student > Postgraduate | 2 | 8% |
| Student > Ph. D. Student | 2 | 8% |
| Researcher | 2 | 8% |
| Other | 2 | 8% |
| Unknown | 7 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 46% |
| Nursing and Health Professions | 3 | 12% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 8% |
| Business, Management and Accounting | 1 | 4% |
| Unknown | 8 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 May 2020.
All research outputs
#8,571,053
of 25,457,858 outputs
Outputs from ClinicoEconomics and Outcomes Research: CEOR
#202
of 525 outputs
Outputs of similar age
#146,075
of 422,188 outputs
Outputs of similar age from ClinicoEconomics and Outcomes Research: CEOR
#6
of 13 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 525 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.0. This one has gotten more attention than average, scoring higher than 52% of its peers.
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We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.