13 Aug 2016
Treatment with rivaroxaban appears to be associated with reduced incidences of hospitalisations and outpatient visits among patients with deep vein thrombosis (DVT) compared with low-molecular-weight heparin (LMWH) and warfarin, according to a study.
Researchers followed adult patients with DVT who initiated treatment with rivaroxaban (n=512) or LMWH/warfarin (n=512) immediately after diagnosis. The number of hospitalisations for all causes and for venous thromboembolism (VTE), healthcare resource utilisation (ER, outpatient, and other visits), as well as healthcare and pharmacy costs were assessed at 1, 2, 3, and 4 weeks after the diagnosis and compared between the two treatment arms.
The rivaroxaban treatment arm showed significantly lower mean all-cause hospitalisation numbers over 1 week (0.012 vs 0.032; p=0.044) and 2 weeks (0.022 vs 0.048; p=0.040) compared with the LMWH/warfarin arm. The mean VTE-related hospitalisation numbers were also significantly lower in the rivaroxaban arm over 1 week (0.008 vs 0.028; p=0.020), 2 weeks (0.016 vs 0.042; p=0.020), and 4 weeks (0.034 vs 0.068; p=0.036).
In terms of all-cause and VTE-related outpatient visits, the mean numbers were markedly lower among patients in the rivaroxaban arm than among those in the LMWH/warfarin arm over 1, 2, 3, and 4 weeks (p<0.001 for all).
Meanwhile, all-cause and VTE-related ER and other visits were comparable between the two treatment groups over the first 4 weeks.
Rivaroxaban users reported lower mean all-cause total healthcare costs than LMWH/warfarin users over the first 2 weeks (week 1: US$2,332 vs $3,428; p<0.001; week 2: $3,108 vs $4,524; p<0.001). Similarly, mean costs associated with all-cause hospitalisations (weeks 1 and 2) and pharmacy (weeks 1 to 4) were significantly lower among rivaroxaban users. Costs related to ER visits (weeks 1 to 4), outpatient visits (weeks 1 to 4), or other visits (with the exception of week 1) did not differ among patients between the two treatment arms.
The findings suggest that rivaroxaban is superior to LMWH/warfarin, with advantages such as simplified care facilitating less healthcare resource utilisation.