Xarelto Reduces Clinical Event Costs Compared to Aspirin

A study at the ASH 2017 Annual Meeting & Exposition measured the cost-effectiveness of Xarelto compared to the cost-effectiveness of aspirin only. 

“The Reduced-dosed [Xarelto (rivaroxaban; Janssen)] in the Long-term Prevention of Recurrent Symptomatic Venous Thromboembolism (EINSTEIN CHOICE) trial found that continued anticoagulation therapy with [Xarelto] (10 mg or 20 mg) vs aspirin for up to 12 months after 6 to 12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) without significantly increasing bleeding rates,” Bruce L. Davidson, MD, MPH, of the University of Washington School of Medicine, and colleagues wrote in the presentation abstract.

Dr Davidson and colleagues measured total health care costs of Xarelto and aspirin by adding the clinical events costs and drug costs from an United States managed care perspective. Cost outcomes were converted to a per-patient per-month figure for primary outcomes. They determined clinical events cost by multiplying the event rate by the cost of care. Then the researcher compared 1-year costs of care for patients with clinical events to that of patients without clinical events. For the study, drug costs were calculated using the drug’s list price and the overall duration of treatment per patient.

Study results showed that patients using Xarelto had a lower per patient per month cost, at $123 for 10 mg and $243 for 20 mg, compared to aspirin patients at $381. The researchers noted that total health care costs were higher due to the higher list price of Xarelto. Total health care costs among Xarelto patients were $23 higher than the aspririn group for those taking 10 mg and $142 higher for those taking 20 mg.

“With a 15% discount for [Xarelto] 10 mg, the lower cost of clinical events for the [Xarelto] treated patients more than fully offset the higher drug costs, and yielded a $20 lower total health care cost,” Dr Davidson and colleagues wrote. “With a 15% discount for [Xarelto] 20 mg, the per patient per month total health care costs remained
higher but with a smaller difference (by $100) for patients treated with [Xarelto] vs aspirin”

—David Costill