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Budget impact analysis of warfarin reversal therapies among hip fracture patients in Finland.

Purmonen T, Törmälehto S, Säävuori N, Kokki H - Drugs R D (2015)

Bottom Line: The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000.In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.The various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.

View Article: PubMed Central - PubMed

Affiliation: Oy Medfiles Ltd, Volttikatu 5, P.O. Box 1450, 70701, Kuopio, Finland, timo.purmonen@medfiles.eu.

ABSTRACT

Background: Hip fractures require operation within 36-48 h, and they are most common in the elderly. A high International Normalized Ratio should be corrected before surgery. In the current study, we analyzed the budget impact of various warfarin reversal approaches.

Methods: Four reversal strategies were chosen for the budget impact analysis: the temporary withholding of warfarin, administration of vitamin K, fresh frozen plasma (FFP), and a four-factor prothrombin complex concentrate (PCC).

Results: We estimated that, annually, 410 hip fracture patients potentially require warfarin reversal in Finland. The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000. In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.

Conclusion: The various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.

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Related in: MedlinePlus

Total costs of different warfarin reversal treatment options in hip fracture patients (n = 410) in Finland, base-case analysis (Initial INR 3.0; bodyweight 70 kg, target INR ≤1.5, incremental hospital day €706). Individual treatments represent 100 % treatment share. Current treatment mix takes into account the current situation according to a survey and 50/50 share of two PCC preparations. FFP fresh frozen plasma, INR international normalized ratio, PCC prothrombin complex concentrate
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Fig1: Total costs of different warfarin reversal treatment options in hip fracture patients (n = 410) in Finland, base-case analysis (Initial INR 3.0; bodyweight 70 kg, target INR ≤1.5, incremental hospital day €706). Individual treatments represent 100 % treatment share. Current treatment mix takes into account the current situation according to a survey and 50/50 share of two PCC preparations. FFP fresh frozen plasma, INR international normalized ratio, PCC prothrombin complex concentrate

Mentions: It was estimated that, annually, 410 hip fracture patients require warfarin reversal in Finland. According to the base case results, the least costly treatment options for warfarin reversal were vitamin K and PCC, which accounted for €289,000 and €428,000 direct healthcare costs, respectively (Fig. 1). The cost of vitamin K treatment depended on incremental inpatient days, whereas PCC-based treatment encompassed drug costs. The drug costs of PCC were partly offset by the reduced healthcare resource use. The most costly treatment, warfarin cessation, cost €1,157,000.Fig. 1


Budget impact analysis of warfarin reversal therapies among hip fracture patients in Finland.

Purmonen T, Törmälehto S, Säävuori N, Kokki H - Drugs R D (2015)

Total costs of different warfarin reversal treatment options in hip fracture patients (n = 410) in Finland, base-case analysis (Initial INR 3.0; bodyweight 70 kg, target INR ≤1.5, incremental hospital day €706). Individual treatments represent 100 % treatment share. Current treatment mix takes into account the current situation according to a survey and 50/50 share of two PCC preparations. FFP fresh frozen plasma, INR international normalized ratio, PCC prothrombin complex concentrate
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4359183&req=5

Fig1: Total costs of different warfarin reversal treatment options in hip fracture patients (n = 410) in Finland, base-case analysis (Initial INR 3.0; bodyweight 70 kg, target INR ≤1.5, incremental hospital day €706). Individual treatments represent 100 % treatment share. Current treatment mix takes into account the current situation according to a survey and 50/50 share of two PCC preparations. FFP fresh frozen plasma, INR international normalized ratio, PCC prothrombin complex concentrate
Mentions: It was estimated that, annually, 410 hip fracture patients require warfarin reversal in Finland. According to the base case results, the least costly treatment options for warfarin reversal were vitamin K and PCC, which accounted for €289,000 and €428,000 direct healthcare costs, respectively (Fig. 1). The cost of vitamin K treatment depended on incremental inpatient days, whereas PCC-based treatment encompassed drug costs. The drug costs of PCC were partly offset by the reduced healthcare resource use. The most costly treatment, warfarin cessation, cost €1,157,000.Fig. 1

Bottom Line: The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000.In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.The various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.

View Article: PubMed Central - PubMed

Affiliation: Oy Medfiles Ltd, Volttikatu 5, P.O. Box 1450, 70701, Kuopio, Finland, timo.purmonen@medfiles.eu.

ABSTRACT

Background: Hip fractures require operation within 36-48 h, and they are most common in the elderly. A high International Normalized Ratio should be corrected before surgery. In the current study, we analyzed the budget impact of various warfarin reversal approaches.

Methods: Four reversal strategies were chosen for the budget impact analysis: the temporary withholding of warfarin, administration of vitamin K, fresh frozen plasma (FFP), and a four-factor prothrombin complex concentrate (PCC).

Results: We estimated that, annually, 410 hip fracture patients potentially require warfarin reversal in Finland. The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000. In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.

Conclusion: The various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.

Show MeSH
Related in: MedlinePlus