The cost-effectiveness of computer-assisted anticoagulant dosage

Results from the European Action on Anticoagulation (EAA) multicentre study

Sue Jowett, S. Bryan, L. Poller, A. M H P Van Den Besselaar, F. J M Van Der Meer, G. Palareti, C. Shiach, A. Tripodi, M. Keown, S. Ibrahim, G. Lowe, M. Moia, A. G. Turpie, J. Jespersen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Increased demand for oral anticoagulation has resulted in wider adoption of computer-assisted dosing in anticoagulant clinics. An economic evaluation has been performed to investigate the cost-effectiveness of computer-assisted dosing in comparison with manual dosing in patients on oral anticoagulant therapy. Methods: A trial-based cost-effectiveness analysis was conducted as part of the EAA randomized study of computer-assisted dosage vs. manual dosing. The 4.5-year multinational trial was conducted in 32 centres with 13219 anticoagulation patients randomized to manual or computer-assisted dosage. The main outcome measures were total health care costs, clinical event rates and cost-saving per clinical event prevented by computer dosing compared with manual dosing. Results: Mean dosing costs per patient were lower (difference: €47) for computer-assisted dosing, but with little difference in clinical event costs. Total overall costs were €51 lower in the computer-assisted dosing arm. There were a larger number of clinical events in the manual dosing arm. The overall difference between trial arms was not significant (difference in clinical events, -0.003; 95% CI, -0.010-0.004) but there was a significant reduction in events with DVT/PE, suggesting computer-assisted dosage with the two study programs (dawn ac or parma 5) was at least as effective clinically as manual dosage. The cost-effectiveness analysis indicated that computer-assisted dosing is less costly than manual dosing. Conclusions: Results indicate that computer-assisted dosage with the two programs (dawn ac and parma 5) is cheaper than manual dosage and is at least as effective clinically, indicating that investment in this technology represents value for money.

Original languageEnglish
Pages (from-to)1482-1490
Number of pages9
JournalJournal of Thrombosis and Haemostasis
Volume7
Issue number9
DOIs
Publication statusPublished - 2009

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Anticoagulants
Multicenter Studies
Cost-Benefit Analysis
Costs and Cost Analysis
Health Care Costs
Outcome Assessment (Health Care)
Technology

Keywords

  • Anticoagulation
  • Computer-assisted dosage
  • Cost-effectiveness

ASJC Scopus subject areas

  • Hematology

Cite this

Jowett, S., Bryan, S., Poller, L., Van Den Besselaar, A. M. H. P., Van Der Meer, F. J. M., Palareti, G., ... Jespersen, J. (2009). The cost-effectiveness of computer-assisted anticoagulant dosage: Results from the European Action on Anticoagulation (EAA) multicentre study. Journal of Thrombosis and Haemostasis, 7(9), 1482-1490. https://doi.org/10.1111/j.1538-7836.2009.03508.x

The cost-effectiveness of computer-assisted anticoagulant dosage : Results from the European Action on Anticoagulation (EAA) multicentre study. / Jowett, Sue; Bryan, S.; Poller, L.; Van Den Besselaar, A. M H P; Van Der Meer, F. J M; Palareti, G.; Shiach, C.; Tripodi, A.; Keown, M.; Ibrahim, S.; Lowe, G.; Moia, M.; Turpie, A. G.; Jespersen, J.

In: Journal of Thrombosis and Haemostasis, Vol. 7, No. 9, 2009, p. 1482-1490.

Research output: Contribution to journalArticle

Jowett, S, Bryan, S, Poller, L, Van Den Besselaar, AMHP, Van Der Meer, FJM, Palareti, G, Shiach, C, Tripodi, A, Keown, M, Ibrahim, S, Lowe, G, Moia, M, Turpie, AG & Jespersen, J 2009, 'The cost-effectiveness of computer-assisted anticoagulant dosage: Results from the European Action on Anticoagulation (EAA) multicentre study', Journal of Thrombosis and Haemostasis, vol. 7, no. 9, pp. 1482-1490. https://doi.org/10.1111/j.1538-7836.2009.03508.x
Jowett, Sue ; Bryan, S. ; Poller, L. ; Van Den Besselaar, A. M H P ; Van Der Meer, F. J M ; Palareti, G. ; Shiach, C. ; Tripodi, A. ; Keown, M. ; Ibrahim, S. ; Lowe, G. ; Moia, M. ; Turpie, A. G. ; Jespersen, J. / The cost-effectiveness of computer-assisted anticoagulant dosage : Results from the European Action on Anticoagulation (EAA) multicentre study. In: Journal of Thrombosis and Haemostasis. 2009 ; Vol. 7, No. 9. pp. 1482-1490.
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