Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Wumaier, Kaidireyahan; Li, Wenqian; Chen, Naifei; Cui, Jiuwei

doi:10.1186/s12959-021-00319-1

Table 1 Parameters for model input with a cycle length of 1 month

From: Direct oral anticoagulants versus low molecular weight heparins for the treatment of cancer-associated thrombosis: a cost-effectiveness analysis

Parameters	Base case	Ranges	Distribution	Source
1-6 month transition probabilities (tp) ^a, %
DOACs
Recurrent DVT	0.33	0.26–0.40	β	[33,34,35,36]
Recurrent PE	0.54	0.43–0.65	β	[33,34,35,36]
Fatal PE	4.45	3.56–5.34	β	[33,34,35,36]
MB	0.70	0.56–0.84	β	[33,34,35,36]
Fatal MB	0.28	0.22–0.34	β	[33,34,35,36]
ICH	0.02	0.016–0.024	β	[33,34,35,36]
Fatal ICH	0	0	β	[33,34,35,36]
Major GI bleeding	1.17	0.94–1.40	β	[33,34,35,36]
CRNMB	1.81	1.45–2.17	β	[33,34,35,36]
Death of any case	4.46	3.57–5.35	β	[33,34,35,36]
Treatment discontinuation	2.91	2.33–3.49	β	[33,34,35,36]
LMWHs
Recurrent DVT	0.61	0.49–0.73	β	[33,34,35,36]
Recurrent PE	0.74	0.59–0.89	β	[33,34,35,36]
Fatal PE	2.24	1.79–2.69	β	[33,34,35,36]
MB	0.47	0.38–0.56	β	[33,34,35,36]
Fatal MB	1.26	1.01–1.51	β	[33,34,35,36]
ICH	0.08	0.06–0.10	β	[33,34,35,36]
Fatal ICH	5.45	4.36–6.54	β	[33,34,35,36]
Major GI bleeding	0.56	0.45–0.67	β	[33,34,35,36]
CRNMB	1.09	0.87–1.31	β	[33,34,35,36]
Death of any case	4.52	3.62–5.42	β	[33,34,35,36]
Treatment discontinuation	4.73	3.78–5.68	β	[33,34,35,36]
OffDVT	1.90	1.52–2.28	β	[37]
OffPE	2.03	1.63–2.44	β	[37]
Costs, $
DOACs 1st month	207.34	165.87–248.81	γ	[38]
DOACs 2nd month onwards	825.89	660.71–991.07	γ	[38]
LMWHs (enoxaparin) 1st month	149.91	119.93–179.89	γ	[38]
LMWH (enoxaparin)2nd month onwards	412.94	365.30–547.94	γ	[38]
DVT	693	329–941	γ	[39]
PE	1121	448–1793	γ	[39]
MB	654	603–704	γ	[40]
ICH	3834	2684–4984	γ	[41]
CRNMB	8.25	5.77–10.72	γ	[41]
Utilities			β
Base	0.95	0.76–1.00	β	[42]
DOACs	0.95	0.76–1.00	β	Assumed^b
LMWHs (enoxaparin)^a	0.85	0.68–1.00	β	[42]
DVT	0.84	0.67–1.00	β	[43]
PE	0.63	0.50–0.76	β	[43]
MB	0.65	0.52–0.78	β	[43]
ICH	0.33	0.26–0.40	β	[43]
CRNMB^a	0.91	0.73–1.00	β	[44]

DVT Deep vein thrombosis, PE Pulmonary embolism, MB Major bleeding, ICH Intracranial hemorrhage, CRNMB Clinically relevant non-major bleeding, DOACs Direct oral anticoagulants, LMWHs Low molecular weight heparins, offDVT Risk of deep-vein thrombosis while off-treatment, offPE Risk of pulmonary embolism while off-treatment
^aUpper and lower bounds estimated to vary ±20% of the mean value for these input parameters estimates
^bUtility associated with DOACs treatment was assumed to be same as base

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