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Budget impact analysis of warfarin reversal therapies among hip fracture patients in Finland

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Published:7th Mar 2015
Author: Purmonen T, Törmälehto S, Säävuori N, Kokki H.
Source: Drugs in R & D
Availability: Free full text
Ref.:Drugs R D. 2015 Mar;15(1):155-62.

Background: Hip fractures require operation within 36–48 h, and they are most common in the elderly. A high International Normalized Ratio should be corrected before surgery. In the current study, we analyzed the budget impact of various warfarin reversal approaches.

Methods: Four reversal strategies were chosen for the budget impact analysis: the temporary withholding of warfarin, administration of vitamin K, fresh frozen plasma (FFP), and a four-factor prothrombin complex concentrate (PCC).

Results: We estimated that, annually, 410 hip fracture patients potentially require warfarin reversal in Finland. The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000. In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.

Conclusion: The various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.

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