Hospital Resource Utilization and Costs Associated With Warfarin Versus Apixaban Treatment Among Patients Hospitalized for Venous Thromboembolism in the United States

Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):261S-268S. doi: 10.1177/1076029618800806. Epub 2018 Nov 15.

Abstract

A real-world US database analysis was conducted to evaluate the hospital resource utilization and costs of patients hospitalized for venous thromboembolism (VTE) treated with warfarin versus apixaban. Additionally, 1-month readmissions were evaluated. Of 28 612 patients with VTE identified from the Premier Hospital database (August 2014-May 2016), 91% (N = 26 088) received warfarin and 9% (N = 2524) received apixaban. Outcomes were assessed after controlling for key patient/hospital characteristics. For index hospitalizations, the average length of stay (LOS) was longer (3.8 vs 3.1 days, P < .001; difference: 0.7 days) and mean hospitalization cost higher (US$3224 vs US$2,740, P < .001; difference: US$484) for warfarin versus apixaban-treated patients. During the 1-month follow-up period, warfarin treatment was associated with a greater risk of all-cause readmission (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.09-1.48, P = .003), major bleeding (MB)-related readmission (OR: 2.10; 95% CI: 1.03-4.27, P = .04), and any bleeding-related readmission (OR: 1.67; 95% CI: 1.09-2.56, P = .02) versus apixaban. The results of this real-world analysis show that compared to warfarin, apixaban treatment was associated with shorter index hospital stays, lower index hospitalization costs, and reduced risk of MB-related readmissions among hospitalized patients with VTE.

Keywords: apixaban; hospital costs; hospital readmissions; venous thromboembolism; warfarin.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Costs and Cost Analysis
  • Enoxaparin / administration & dosage
  • Enoxaparin / economics*
  • Female
  • Humans
  • Length of Stay / economics*
  • Male
  • Middle Aged
  • Patient Readmission / economics*
  • Pyrazoles / administration & dosage
  • Pyrazoles / economics*
  • Pyridones / administration & dosage
  • Pyridones / economics*
  • Retrospective Studies
  • United States
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / economics*
  • Warfarin / administration & dosage
  • Warfarin / economics*

Substances

  • Enoxaparin
  • Pyrazoles
  • Pyridones
  • apixaban
  • Warfarin