A multi-perspective cost-effectiveness analysis comparing rivaroxaban with enoxaparin sodium for thromboprophylaxis after total hip and knee replacement in the German healthcare setting

Table 3 Resource consumption and costs (€) of pre-discharge venous thromboembolism incurred in hospital and after discharge (outpatient) (costs in 2010 euros)

Resource consumption		DVT after THR (units)	DVT after TKR (units)	nf PE after THR(units)	nf PE after TKR(units)	Unit prices (€)	Source
In hospital	Diagnostics
Blood gas analysis		0.0	0.0	1.0	1.0	4.95	[19, 27, 28], UTHC
	D-dimer	1.0	1.0	1.0	1.0	9.90	[19, 27, 28], UTHC
	Doppler ultrasound	1.0	1.0	0.0	0.0	9.90	[19, 27, 28], UTHC
	Chest X-ray	0.0	0.0	1.0	1.0	7.70	[19, 27, 28], UTHC
	ECG	0.0	0.0	1.0	1.0	8.36	[19, 27, 28], UTHC
	CT	0.0	0.0	1.0	1.0	154.00	[19, 27, 28], UTHC
	Echocardiography	0.0	0.0	1.0	1.0	27.50	[19, 27, 28], UTHC
	Treatment
	Enoxaparin sodium	12.0	12.0	12.0	12.0	9.98	[19, 27–29]
	Subcutaneous injection	12.0	12.0	12.0	12.0	2.20	[19, 27, 28], UTHC
	Blood sample (TZ)	1.0	1.0	1.0	1.0	5.50	[19, 27, 28], UTHC
	Phenprocoumon (days)	10.3	10.0	11.0	12.7	0.17	[19, 27–29]
	Anticoagulant monitoring¹	2.0	2.0	2.0	2.0	8.80	[19, 27, 28], UTHC
	Compression therapy	1.0	1.0	1.0	1.0	5.23	[19, 27, 28], UTHC
	Additional LOS² (€)	1,086.27	919.15	1,716.45	1,973.73		[4, 16, 19, 26]
Total costs for hospital (€)		1,282.27	1,115.14	2,105.22	2,362.79
In hospital	Extra DRG reimbursement³	0	0	0	191.46
Outpatient	Treatment
	Outpatient visit⁴	1.0	1.0	1.0	1.0	53.16	[19, 27, 28, 30]
	Phenprocoumon (days)	79.7	80.0	79.0	77.3	0.17	[19, 27, 28, 30]
	INR measurement	10.0	10.0	10.0	10.0	1.68	[19, 27, 28, 30]
	Compression stockings	2.0	2.0	2.0	2.0	36.90	[19, 27, 28, 30]
Total costs for health insurance (€)		157.35	157.40	157.23	348.40

DVT = deep vein thrombosis, THR = total hip replacement, TKR = total knee replacement, nf PE = non-fatal pulmonary embolism, ECG = electrocardiogram, CT = computerized tomography with contrast agent, TZ = thrombocytes, LOS = length of stay, UTHC = University teaching hospital in Cologne, Germany.
¹Including blood sample and INR (international normalized ratio) measurement.
²Additional hospital days are derived from Tilleul et al. [26] and calculated as 3.9 days for DVT and 4.6 days for non-fatal PE after THR;
3.3 days for DVT and 6.0 days for non-fatal PE after TKR.
³DRG reimbursement for an extended hospital stay beyond 18 days.
⁴Flat rate including all outpatient visits and blood samples every quarter (3 months).

ISSN: 1472-6963