Healthcare resource utilization and costs after initiating direct-acting oral anticoagulants or low molecular weight heparins in patients with venous thromboembolism

Venous thromboembolism (VTE) can lead to significant healthcare resource utilization (HcRU) and costs. First-line treatments such as direct-acting oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) are utilized for VTE management. There are limited observational studies to determine...

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Veröffentlicht in:Vascular medicine (London, England) Jg. 30; H. 2; S. 197
Hauptverfasser: Okoye, Godwin, Ben-Umeh, Kenechukwu C, Avanceña, Anton Lv, Onukwugha, Eberechukwu
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England 01.04.2025
Schlagworte:
Administration, Oral
Adult
Aged
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Anticoagulants - economics
Cost Savings
Cost-Benefit Analysis
Databases, Factual
Drug Costs
Factor Xa Inhibitors - administration & dosage
Factor Xa Inhibitors - adverse effects
Factor Xa Inhibitors - economics
Female
Health Care Costs
Health Resources - economics
Heparin, Low-Molecular-Weight - administration & dosage
Heparin, Low-Molecular-Weight - adverse effects
Heparin, Low-Molecular-Weight - economics
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Retrospective Studies
Time Factors
Treatment Outcome
United States
Venous Thromboembolism - diagnosis
Venous Thromboembolism - drug therapy
Venous Thromboembolism - economics
United States
low molecular weight heparin
Direct oral anticoagulant (DOAC)
healthcare cost
venous thromboembolism (VTE)
healthcare use
ISSN:1477-0377, 1477-0377
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Zusammenfassung:Venous thromboembolism (VTE) can lead to significant healthcare resource utilization (HcRU) and costs. First-line treatments such as direct-acting oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) are utilized for VTE management. There are limited observational studies to determine which first-line drug for VTE is associated with lower HcRU and cost. Therefore, we sought to compare HcRU and costs of commercially insured patients with VTE who initiated DOAC or LMWH in the US. We utilized Merative MarketScan Research Database (2016-2021) to identify adults initiating DOAC or LMWH for VTE. Baseline measures were assessed 12 months prior to the index date of drug initiation. Inverse probability of treatment weighting was used to control confounding. For HcRU, logistic regression was used to model emergency room and inpatient visits and the negative binomial count model was used for outpatient visits. The average marginal effect for total healthcare cost comparing DOAC with LMWH users was estimated using a generalized linear model. HcRU and costs were evaluated for 12 months posttreatment initiation. DOAC users had lower odds of inpatient visits (adjusted odds ratio [aOR] 0.53, 95% CI 0.46 to 0.59), emergency room visits (aOR 0.86, 95% CI 0.73 to 0.99), and outpatient visits (adjusted incident rate ratio 0.52, 95% CI 0.50 to 0.54) in comparison to LMWH users. DOAC users had lower total healthcare costs of -$9573 (95% CI -$11,149 to -$7997) (US dollars). This cohort study suggests that DOAC use is associated with fewer inpatient, outpatient, and emergency room visits, and lower healthcare costs compared to LMWH use for VTE management.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1477-0377
1477-0377
DOI:10.1177/1358863X241305097