Cost–Effectiveness of Rivaroxaban Versus Heparins for Prevention of Venous Thromboembolism After Total Hip or Knee Surgery in Sweden

Lars Ryttberg; Alex Diamantopoulos; Fiona Forster; Michael Lees; Anina Fraschke; Ingela Björholt


Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(5):601-615. 

In This Article

Five-year View

Rivaroxaban, the direct factor Xa inhibitor apixaban and the direct thrombin inhibitor dabigatran are the most advanced new oral anticoagulants in development. They all have characteristics that simplify their use and overcome the drawbacks associated with the established anticoagulants. These include an oral route of administration, a rapid onset and offset of action, a wide therapeutic window, no requirement for routine coagulation monitoring, and minimal food or drug interactions. The number of hip replacement procedures conducted in Sweden has risen from only six operations in 1976 to 14,105 in 2008, with an increase of almost 4000 operations per year in Sweden between 1998 and 2008.[104] A similar trend has occurred in knee replacement surgery in Sweden. In the year 2000, it was estimated that, due to an aging population, the number of knee replacement operations would increase by 36% to 7580 operations per year by 2030.[105] However, this level was reached by 2002 and has since continued to rise. These increases will impose a burden on the Swedish healthcare system. The adoption of rivaroxaban instead of LMWH for thromboprophylaxis after THR and TKR should substantially reduce costs due to events avoided, with the additional result of a substantial improvement in the QoL of these patient groups.


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