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. Author manuscript; available in PMC: 2014 Feb 6.
Published in final edited form as: Pharmacoeconomics. 2010;28(7):521–538. doi: 10.2165/11535210-000000000-00000

Table 6.

Summary of Cost-effectiveness Studies Comparing Extended Duration Therapy with Short Duration Therapy

study ID Exact Horizon Comparator 1 Comparator 2 Major Bleeding rate (%) Extended / Short DVT rate Major Bleeding rate (%) Extended / Short PE rate Major Bleeding rate (%) Extended / Short Death Rate Major Bleeding rate (%) Extended / Short Cost-Effectiveness Result in 2009 USD*
THR Results from Short Horizon Analysis
Bergqvist 1999 19-23 days post discharge Enoxaparin 40 mg × 30 days Enoxaparin 2.04 / 4.17 1.53 / 5.34 0 / 1.53 0 / 0 Extended duration LMWH dominated
Dahl 2003 35 days Dalteparin 5,000 IU qd × 28-35 days Dalteparin 5,000 Ius × 7-15 days ns / ns 5.50 / 8.5 0.5 / 2.3 ns / ns Extended duration LMWH dominated
McCullagh 2009 180 days Rivarobaxan 10 mg × 35 days Dabigatran 220 mcg × 14 days 0.08 / 2.0 0.29 / 0.93 0.40 / 0.50 0 / 0 Extended duration rivaroxaban dominated
McCullagh 2009 180 days Rivarobaxan 10 mg × 35 days Enoxaparin 40 mg × 14 days 0.08 / 0.08 0.29 / 2.2 0.12 / 0.50 0 / 0 Extended duration rivaroxaban dominated
Dahl 2003 35 days Dalteparin 5,000 IU qd × 28-35 days Warfarin ns / ns 5.5/ 8.3 0.5 / 0.9 ns / ns Extended duration LMWH ICER = $120 /VTE avoided
Skedgel 2007 90 days Warfarin 5 mg qd × 28 days post discharge Regimen for hospital period not specified 0.54 / 0.11 1.57 / 3.28 0.29 / 0.61 0.05 / 0.10 Extended duration warfarin ICER = $3,200 /VTE avoided
Davies 2000 90 days Enoxaparin 40 mg qd × hospitalization period + 21 days Enoxaparin 40 mg qd for hospitalization period ns / ns 1.8 / 7.4 ns / ns 0.1 / 0.7 Extended duration LMWH ICER = $7800 /VTE avoided
Dranitsaris 2009 35 days Dalteparin 5,000 IUs × 35 days Warfarin INR 2-3 × 10 days 6.6 / 4.5 3.72 / 6.7 0 / 0 0 / 0 Extended duration LMWH ICER $8,000 /VTE avoided
Detournay 1998 30-35 days Enoxaparin 40 mg qd × 30-35 days Enoxaparin 40 mg qd × 7-14 days ns / ns Extend-ed 16.0-21.1% more events avoided ns / ns Extended 0.60-0.78% more events avoided Extended duration LMWH ICER= $10,000 / VTE avoided
Dranitsaris 2009 35 days Dalteparin 5,000 IUs × 35 days Dalteparin 5,000 IUs × 10 days 6.6 / 6.7 3.72 / 5.3 0 / 0 0 / 0 Extended LMWH ICER $13,200 / VTE avoided
Bischopf 2006 30 days Fondaparinux × 28 days; dose not specified Fondaparinux × 7 days; dose not specified ns / ns Fond 1.6% more events avoided Fond 0.5% more events avoided 0 / 0.1 Extended duration fondaparinux ICER = $13,300 / Life-year gained
Skedgel 2007 90 days LMWH 40 mg qd × 28 days post discharge Regimen for hospital period not specified 0.11 / 0.11 1.10 / 3.28 0.20 / 0.61 0.03 / 0.10 Extended duration LMWH ICER = $27,400 / VTE avoided
McCullagh 2009 180 days Dabigatran 220 mcg × 35 days Enoxaparin 40 mg × 14 days 2 / 0.08 0.93 / 2.2 0.40 / 0.50 0 / 0 Extended duration dabigatran ICER = $730,00 / VTE avoided
THR Results from Long Horizon Analysis
Bischof 2006 5 years Fondaparinux × 28 days; dose not specified Fondaparinux × 7 days; dose not specified ns / ns ns / ns ns / ns ns / ns Extended duration fondaparinux dominates
Haentjens 2004 1 year Enoxaparin × 42 days; dose not specified Enoxaparin × 12 days; dose not specified 1.7 / 1.7 5.12 / 8.95 ns / ns ns / ns Extended duration LMWH ICER = $9,300 / QALY gained
TKR Results from Short Horizon Analysis
Dranitsaris 2009 35 days Dalteparin 5,000 IUs × 35 days Warfarin INR 2-3 × 10 days 6.7 / 4.8 4.0 / 5.8 0 / 0 0 / 0 Extended LMWH ICER $14,600 / VTE
Dranitsaris 2009 35 days Dalteparin 5,000 IUs × 35 days Dalteparin 5,000 IUs × 10 days 6.7 / 6.9 4.0 / 4.4 0 / 0 0 / 0 Extended duration LMWH ICER $60,600 / VTE avoided
TKR Result from Long Horizon Analysis
Haentjens 2004 1 year Enoxaparin 40 mg qd × 42 days Enoxaparin × 12 days; dose not specified 0.5 / 0.5 6.81 / 7.70 ns / ns ns / ns Extended duration LMWH ICER = $73,300 / QALY gained

Abbreviations: LMWH = low molecular weight heparin, ns = not specified, VTE = venous thromboembolism, QALY = quality adjusted

*

Cost-effectiveness result is the incremental cost-effectiveness ratio (ICER). To arrive at ICER values, incremental costs reported in foreign currencies were inflated or deflated according to readily available consumer price indices, converted to USD via 2005 World Health Organization purchasing price parity indices, and then inflated to 2009 USD using the Bureau of Labor Statistics consumer price calculator available at www.bls.gov.