Cost-effectiveness of edoxaban versus dalteparin for the treatment of cancer-associated thrombosis
Malignancy is a well-established risk factor for venous thromboembolism and while low-molecular-weight heparin therapy has been standard of care for cancer-associated thrombosis for many years, many patients find injection therapy burdensome. The direct oral anticoagulant edoxaban has been shown to be noninferior to dalteparin for the treatment of cancer-associated thrombosis. In a Markov simulation model, edoxaban with 6-month time horizon and a United States societal perspective with 2017 US dollars, edoxaban was the preferred strategy in the general cancer population (6-month cost $6061 with 0.34 quality adjusted life years) and in a subgroup of patients with gastrointestinal malignancy (6-month cost $7227 with 0.34 quality adjusted life years). The incremental cost effectiveness ratio of dalteparin compared to edoxaban was $1,873,535 in the general oncology population and $694,058 in the gastrointestinal malignancy population.
KeywordsCost-effectiveness Edoxaban Dalteparin Cancer-associated thrombosis Venous thromboembolism
NTC and JMC designed the study, analyzed the data, critically evaluated and edited the manuscript, and provided final approval. NTC built the Markov model and ran the analyses.
Compliance with ethical standards
Conflict of interest
NT.C.: no financial conflicts of interest. J.M.C.: Honoraria or consulting fees from Bristol-Myers Squibb, Portola, Research funding to the institution CSL Behring.
- 4.Shah S, Rubin N, Khorana AK. Economic burden of venous thromboembolism in cancer patients—a comparative analysis between matched patients with cancer with and without a diagnosis of venous thromboembolism. Blood. 2018;132(366):Abstract 366Google Scholar
- 8.Dalteparin. In: RED BOOK Online [database on the Internet]. Greenwood Village (CO): Truven health analytics; January 15, 2018. www.micromedexsolutions.com
- 9.Edoxaban. In: RED BOOK Online [database on the Internet]. Greenwood Village (CO): Truven health analytics; January 15, 2018. www.micromedexsolutions.com