Rivaroxaban for the treatment of deep vein thrombosis and ...

Figure 8: Tornado plot - Net Monetary Benefit of rivaroxaban vs. LMWH/VKA, 3 months
of treatment, lifetime horizon, duration specific inputs (reproduction of Figure 3, p. 31,
Clarification letter 17 December 2011)
OWSA Tornado diagram for strategy (Net monetary benefit, QALY based): 1 vs 2 (lifetime)
HR of VTE in 3 months patient group (EINSTEIN acute)
HR of major bleed in 3 months patient group (EINSTEIN acute)
Probability of major bleed in 3 months patient group (EINSTEIN acute)
Probability of VTE in 3 months patient group (EINSTEIN acute)
Probability major bleed is intra-cranial
Cost of ambulatory visits (OPs by different treatment setting plus
district nurse)
Number of warfarin monitoring visits during initiation period (months 1-
3)
Cost of GP visit VKA
Death given Untreated PE (Prandoni)
Proportion of patients who self inject LMWH
Probability that recurrent VTE is DVT
Disutility associated with WARF
Death given EC major bleed
State-related mortality (all parameters)
Mean age cohort
Results for the PSA were run over 1,000 iterations, using effectiveness data specific to patients treated
for 3 months under a lifetime horizon are presented in Figure 9 for the cost-effectiveness plane and
Figure 10 for the cost effectiveness acceptability curve (CEAC).
-3,500 -3,000 -2,500 -2,000 -1,500 -1,000 -500 0 500 1,000 1,500
The manufacturer reported that rivaroxaban had a 58.4% chance of being cost-effective at a WTP of
£20,000 per QALY gained. Rivaroxaban was dominant (provided more QALYs at a lower cost) in
48.5% of cases and was dominated (provided less QALYs at a higher cost) in 6.4% of iterations.
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