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

Figure 17: Tornado plot - Net Monetary Benefit of rivaroxaban vs. LMWH/VKA, 6 months
of treatment in cancer patients, lifetime horizon (reproduction of Figure 13, p. 43, Clarification
letter 17 December 2011)
OWSA Tornado diagram for strategy (Net monetary benefit, QALY based): 1 vs 2 (lifetime)
Tx effect riva vs LMWH - Primary analysis - Major bleeds (OR)
Tx effect riva vs LMWH - Primary analysis - VTE (HR)
Proportion of patients who self inject LMWH
Alternative cancer NMA (high =secondary 1, low secondary 2)
Cost of LMWH (daily dose - chronic)
Cancer subgroup life expectancy
Tx effect riva vs LMWH - Primary analysis - CRNM bleeds (OR)
HR of major bleed (EINSTEIN)
Cancer subgp - baseline risk adjust (applied to warfarin) - VTE
Cancer subgp - baseline risk adjust (applied to warfarin) - Major bleed
Probability major bleed is intra-cranial
HR of VTE (EINSTEIN)
Cost of ambulatory visits (OPs by different treatment setting plus
district nurse)
Cost of LMWH (daily dose - acute period)
Probability of major bleed over 0-3 months (EINSTEIN)
Results for the PSA were run over 1,000 iterations under a lifetime horizon are presented in Figure 18
for the cost-effectiveness plane and Figure 19 for the CEAC.
0 2,000 4,000 6,000 8,000 10,000 12,000
The manufacturer reported that rivaroxaban had a 95.0% 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
61.5% of cases.
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