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

5.2.2.2 Subgroup analysis – cancer patients
In its original submission to NICE, 1 the manufacturer submitted a cost-minimisation analysis in a
subgroup of patients with cancer treated for 6 months comparing rivaroxaban against LMWH only
(dalteparin). In addition to this analysis, an exploratory cost-effectiveness analysis was requested by
ERG.
5.2.2.2.1. Results for the cost-minimisation analysis in cancer patients treated for 6 months
The manufacturer presented a cost-minimisation analysis comparing patients treated over 6 months
with rivaroxaban against dalteparin in the oncology setting. The manufacturer only included drug
acquisition costs as cancer patients are assumed to be already frequently monitored and that the
administration of dalteparin would not impose substantial additional burden outside of drug costs.
The manufacturer estimated that the use of rivaroxaban was associated with a savings of £904
compared with patients treated with LMWH (dalteparin).
Table 34: Cost minimisation of rivaroxaban vs. LMWH in the cancer subgroup
(reproduction of Table 79, p. 209, MS 1 November 2011)
Items Rivaroxaban Dalteparin Reference
Technology cost £2.10 per tablet Month 1: £8.47 per day.
Months 2-6: £7.06 per day.
See Table 49
Mean cost of technology treatment
Initial treatment £2.10 x 21 x 2 = £88.2 £8.47 x 30 = £254.10
Extended treatment
(remainder of 6 months
– 180 days)
£333.90
£7.06 x 152.5 = £1,076.65
Additional cost components
Monitoring cost: No monitoring visits No monitoring visits Guidelines of the
Association for
Palliative Medicine
for Great Britain
and Ireland 38
Administration £0 £0 Assumed
Total over 6 months £427.36 £1,330.75 Derived
Saving associated with
rivaroxaban
£903.39 Derived
130
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