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

Figure 14: Tornado plot - Net Monetary Benefit of rivaroxaban vs. LMWH/VKA, 12
months of treatment, lifetime horizon, duration specific inputs (reproduction of Figure 9, p. 36,
Clarification letter 17 December 2011)
Results for the PSA were run over 1,000 iterations, using effectiveness data specific to patients treated
for 12 months under a lifetime horizon are presented in Figure 15 for the cost-effectiveness plane and
Figure 16 for the CEAC.
OWSA Tornado diagram for strategy (Net monetary benefit, QALY based): 1 vs 2 (lifetime)
HR of major bleed in 12 months patient group (EINSTEIN acute)
HR of VTE in 12 months patient group (EINSTEIN acute)
State-related mortality (all parameters)
Discount rate applied to outcomes
Death given treated PE (overall)
Mean age cohort
Cost of ambulatory visits (OPs by different treatment setting plus
district nurse)
Probability of VTE in 12 months patient group over 0-3 months
(EINSTEIN acute)
Number of warfarin monitoring visits per period of 3 months, after
initiation period
Cost of GP visit VKA
Disutility associated with WARF
Probability that recurrent VTE is DVT
Probability of VTE in 12 months patient group over 3-6 months
(EINSTEIN acute)
Number of warfarin monitoring visits during initiation period (months 1-
3)
Probability of VTE in 12 months patient group over 6-12 months
(EINSTEIN acute)
-200 0 200 400 600 800 1,000 1,200 1,400 1,600
The manufacturer reported that rivaroxaban had a 95.4% 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
48.8% of cases and was dominated (provided less QALYs at a higher cost) in 2.7% of iterations.
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