CUSTO-EFECTIVIDADE QUE COMPARA OS CUSTOS E CONSEQUÊNCIAS ASSOCIADOS A RIVAROXABANO RELATIVAMENTE A ENOXAPARINA NA PREVENÇÃO DO TROMBOEMBOLISMO VENOSO EM DOENTES ADULTOS SUBMETIDOS A ARTOPLASTIA ELETIVA DA ANCA OU JOELHO

A cost-effectiveness model was developed in order to evaluate the costs and consequences of rivaroxaban versus enoxaparin for the prevention of venous thromboembolism in adult patients undergoing hip or knee replacement surgery. This analysis was run from the societal perspective, over a five-year time horizon in the Portuguese setting. A five percent discount rate was applied to both costs and consequences. The model is divided into three modules: prophylaxis, post-prophylaxis and long-term complications. Transition probabilities were based on the RECORD-1 and RECORD-3 clinical trials, which compared rivaroxaban 10 mg once-daily (OD) with enoxaparin 40 mg OD, and published literature. Sensitivity analyses were performed in order to evaluate the robustness and uncertainty of the model. The results obtained suggest that rivaroxaban 10 mg OD, started six to ten hours after surgery, is a dominant strategy versus enoxaparin 40 mg OD, started on the evening before the surgery. The use of rivaroxaban in this therapeutic indication provides the efficient use of the scarce resources since it’s associated with better clinical outcomes at a lower cost.