Apixaban for the prevention of venous thromboembolism in people ...

5 COST EFFECTIVENESS
5.1 ERG comment on manufacturer’s review of cost-effectiveness evidence
5.1.1 State objective of cost effectiveness review. Provide description of manufacturers search
strategy and comment on whether the search strategy was appropriate. If the manufacturer did
not perform a systematic review, was this appropriate?
The objective was to perform a systematic review of economic evaluations for interventions for the
prophylaxis of venous thromboembolism (VTE) in patients undergoing elective total knee and hip
replacement.
5.1.2 State the inclusion/exclusion criteria used in the study selection and comment on
whether they were appropriate.
The inclusion criteria for the literature review were:
Patients undergoing hip and/or knee replacement or, in a mixed population, where information
was reported specifically for the hip and/or knee replacement patient population.
Graduated elastic compression stockings / anti-embolism stockings (GCS)
Intermittent pneumatic compression (IPCD) devices
Foot pumps or foot impulse devices (FID)
Vena cava filters
Aspirin or antiplatelet therapy
Low-dose unfractionated heparin administered subcutaneously (UFH)
Low molecular weight heparin (LMWH)
The synthetic pentasaccharide, Fondaparinux
Vitamin K Antagonists (For example, warfarin, coumarin)
Early mobilisation
Foot elevation
Hydration
New oral anticoagulants licensed during the guideline development period (rivaroxaban and
dabigatran)
Papers not meeting the inclusion criteria above or published in a language other than English were
excluded.
5.1.3 What studies were included in the cost effectiveness review and what were excluded?
Where appropriate, provide a table of identified studies. Please identify the most important cost
effectiveness studies.
Based on the search and the inclusion and exclusion criteria, the cost effectiveness review included 96
studies.In total 14 UK studies were included:
eight publications (Davies et al, 36 Davies and Saltzman, 37 Drummond et al, 38 Gordois et al, 39
McCullagh et al 40 , Nicolaides and Bosanquet, 41 Wolowacz et al, 42 Wolowacz et al 43 ).
three abstracts (Diamantopoulos, 44 Diamantopoulos, 45 Ryttberg 46 )
three UK HTA documents (Dabigatran STA 47, 48 Rivaroxaban STA, 34, 49 NICE guidelines 2010 3 ).
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