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The Cost Implications of Dabigatran in Patients with Myocardial Injury After Non-Cardiac Surgery

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Andre Lamy
  • Wesley Tong
  • Rajibul Mian
  • Jessica Vincent
  • Wojciech Szczeklik
  • Bruce M Biccard
  • Emmanuelle Duceppe
  • Maria Graza Franzosi
  • Sadeesh K Srinathan
  • Christian S Meyhoff
  • Joel Parlow
  • Denis Xavier
  • P J Devereaux
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BACKGROUND: The Management of Myocardial Injury after Non-Cardiac Surgery (MANAGE) trial demonstrated that dabigatran 110 mg twice daily was more effective than placebo in preventing the primary composite outcome of vascular mortality, non-fatal myocardial infarction, non-hemorrhagic stroke, peripheral arterial thrombosis, amputation and symptomatic venous thromboembolism in patients with myocardial injury after non-cardiac surgery (MINS). The cost implications of dabigatran for this population are unknown but are important given the significant clinical implications.

METHODS: Hospitalized events, procedures, and study and non-study medications were documented. We applied Canadian unit costs to healthcare resources consumed for all patients in the trial, and calculated the average cost per patient in Canadian dollars for the duration of the study (median follow-up of 16 months). A sensitivity analysis was performed using only Canadian patients, and subgroup analyses were also conducted.

RESULTS: The total study cost for the dabigatran group was $9985 per patient, compared with $10,082 for placebo, a difference of - $97 (95% confidence interval [CI] - $2128 to $3672). Savings arising from fewer clinical events and procedures in the dabigatran 110 mg twice-daily group were enough to offset the cost of the study drug. In Canadian patients, the difference was $250 (95% CI -$2848 to $4840). Both differences were considered cost neutral. Dabigatran 110 mg twice daily was cost saving or cost neutral in many subgroups that were considered.

CONCLUSION: Dabigatran 110 mg twice daily was cost neutral for patients in the MANAGE trial. Our cost findings support the use of dabigatran 110 mg twice daily in patients with MINS.

TRIAL REGISTRATION: ClinicalTrials.gov identifier number NCT01661101.

OriginalsprogEngelsk
TidsskriftAmerican Journal of Cardiovascular Drugs
Vol/bind22
Udgave nummer1
Sider (fra-til)83-91
ISSN1175-3277
DOI
StatusUdgivet - 2022

Bibliografisk note

© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

ID: 68495987