Craig I Coleman1, Gregory J Fermann2, Erin R Weeda1, Philip S Wells3, Veronica Ashton4, Concetta Crivera4, Thomas J Bunz5, Peter Wildgoose4, Jeff R Schein4, W Frank Peacock6. 1. 1 School of Pharmacy, University of Connecticut, Storrs, CT, USA. 2. 2 Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA. 3. 3 Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Canada. 4. 4 Janssen Scientific Affairs, LLC, Raritan, NJ, USA. 5. 5 New England Health Analytics, LLC, Granby, CT, USA. 6. 6 Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
Abstract
OBJECTIVE: We sought to compare the length of stay (LOS) and total costs for patients with pulmonary embolism (PE) treated with either rivaroxaban or parenterally bridged warfarin. METHODS: This retrospective claims analysis was performed in the Premier Database from November 2012 to March 2015. Adult patients were included if they had a hospital encounter for PE (an International Classification of Diseases, Ninth Revision code = 415.1×) in the primary position, a claim for ≥1 diagnostic test for PE on day 0 to 2, and initiated rivaroxaban or parenteral anticoagulation/warfarin. Rivaroxaban users (allowing ≤2 days of prior parenteral therapy) were 1:1 propensity score matched to patients receiving parenterally bridged warfarin. Length of stay, total costs, and readmission for venous thromboembolism (VTE) or major bleeding during the same or subsequent 2 months following the index event were compared between cohorts. Analysis restricted to patients with low-risk PE was also performed. RESULTS: Characteristics of the matched PE cohorts (n = 3466 per treatment) were well balanced. Rivaroxaban use was associated with a 1.36-day shorter LOS and $2304 reduction in total costs compared to parenterally bridged warfarin ( P < .001 for both). Rates of readmission for VTE were similar between cohorts (1.7% vs 1.6%; P = .64). No difference was observed between treatments for readmission for major bleeding (0.2% vs 0.2%; P > .99). In analyses restricted to low-risk patients (n = 1551 per treatment), rivaroxaban was associated with a 1.01-day and a $1855 reduction in LOS and costs, respectively ( P < .001 for both). Rates of readmission were again similar between treatments ( P > .56 for all). CONCLUSION: Rivaroxaban significantly reduced hospital LOS and costs compared to parenterally bridged warfarin, without increasing the risk of readmission.
OBJECTIVE: We sought to compare the length of stay (LOS) and total costs for patients with pulmonary embolism (PE) treated with either rivaroxaban or parenterally bridged warfarin. METHODS: This retrospective claims analysis was performed in the Premier Database from November 2012 to March 2015. Adult patients were included if they had a hospital encounter for PE (an International Classification of Diseases, Ninth Revision code = 415.1×) in the primary position, a claim for ≥1 diagnostic test for PE on day 0 to 2, and initiated rivaroxaban or parenteral anticoagulation/warfarin. Rivaroxaban users (allowing ≤2 days of prior parenteral therapy) were 1:1 propensity score matched to patients receiving parenterally bridged warfarin. Length of stay, total costs, and readmission for venous thromboembolism (VTE) or major bleeding during the same or subsequent 2 months following the index event were compared between cohorts. Analysis restricted to patients with low-risk PE was also performed. RESULTS: Characteristics of the matched PE cohorts (n = 3466 per treatment) were well balanced. Rivaroxaban use was associated with a 1.36-day shorter LOS and $2304 reduction in total costs compared to parenterally bridged warfarin ( P < .001 for both). Rates of readmission for VTE were similar between cohorts (1.7% vs 1.6%; P = .64). No difference was observed between treatments for readmission for major bleeding (0.2% vs 0.2%; P > .99). In analyses restricted to low-risk patients (n = 1551 per treatment), rivaroxaban was associated with a 1.01-day and a $1855 reduction in LOS and costs, respectively ( P < .001 for both). Rates of readmission were again similar between treatments ( P > .56 for all). CONCLUSION:Rivaroxaban significantly reduced hospital LOS and costs compared to parenterally bridged warfarin, without increasing the risk of readmission.
Authors: Jeffrey Trocio; Virginia M Rosen; Anu Gupta; Oluwaseyi Dina; Lien Vo; Patrick Hlavacek; Lisa Rosenblatt Journal: Clinicoecon Outcomes Res Date: 2018-12-19
Authors: Pablo Demelo-Rodríguez; Francisco Galeano-Valle; Irene García-Fernández-Bravo; Sandra Piqueras-Ruiz; Luis Álvarez-Sala-Walther; Jorge Del Toro-Cervera Journal: Medicine (Baltimore) Date: 2019-01 Impact factor: 1.817
Authors: Steven Deitelzweig; Jennifer D Guo; Patrick Hlavacek; Jay Lin; Gail Wygant; Lisa Rosenblatt; Anu Gupta; Xianying Pan; Jack Mardekian; Melissa Lingohr-Smith; Brandy Menges; Alexander Marshall; Anagha Nadkarni Journal: Clin Appl Thromb Hemost Date: 2018-11-15 Impact factor: 2.389