Pulmonary Embolism Inpatients Treated With Rivaroxaban Had Shorter Hospital Stays and Lower Costs Compared With Warfarin

Jay M. Margolis, Steven Deitelzweig, Jeffrey Kline, Oth Tran, David M. Smith, Concetta Crivera, Brahim Bookhart, Jeff Schein

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose Using real-world data, this study compares inpatient length of stay (LOS) and costs for patients with a primary diagnosis of pulmonary embolism (PE) initiating treatment with oral anticoagulation with rivaroxaban versus warfarin. Methods Hospitalizations from MarketScan's Hospital Drug Database were selected from November 1, 2012, through December 31, 2013, for adults with a primary diagnosis of PE initiating treatment with rivaroxaban or warfarin. Warfarin patients were matched 1:1 to rivaroxaban patients using exact and propensity score matching. Hospital LOS, treatment patterns, and hospitalization costs were evaluated. Findings Matched cohorts included 751 rivaroxaban-treated patients and 751 warfarin-treated patients. Adjusted mean LOS was 3.77 days for rivaroxaban patients (95% CI, 3.66–3.87 days) and 5.48 days for warfarin patients (95% CI, 5.33–5.63 days; P < .001). Mean (SD) LOS was shorter for patients taking rivaroxaban whether admission was for provoked PE (rivaroxaban: 5.2 [5.1] days; warfarin: 7.0 [6.5] days; P < .001) or unprovoked PE (rivaroxaban: 3.4 [2.3] days; warfarin: 5.1 [2.7] days; P < .001). Mean (SD) days from first dose to discharge were 2.5 (1.7) (rivaroxaban) and 4.0 (2.9) (warfarin) when initiated with parenteral anticoagulants (P < .001) and 2.7 (1.7) (rivaroxaban) and 4.0 (2.2) (warfarin) without parenteral anticoagulants (P < .001). The rivaroxaban cohort incurred significantly lower unadjusted mean (SD) hospitalization costs (rivaroxaban: $8473 [$9105]; warfarin: $10,291 [$9185]; P < .001), confirmed by covariate adjustment with generalized linear modeling estimating predicted mean hospitalization costs of $8266 for rivaroxaban patients (95% CI, $7851–$8681) and $10,511 for warfarin patients (95% CI, $10,031–$10,992; P < .001). Implications patients with PE treated with rivaroxaban incurred significantly lower hospitalization costs by $2245 per admission compared with patients treated with warfarin, which was attributable to cost offsets from 1.71 fewer days of stay in the hospital.

Original languageEnglish (US)
Pages (from-to)2496-2503
Number of pages8
JournalClinical Therapeutics
Volume38
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

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Warfarin
Pulmonary Embolism
Inpatients
Length of Stay
Costs and Cost Analysis
Hospitalization
Rivaroxaban
Anticoagulants
Pharmaceutical Databases
Propensity Score
Therapeutics

Keywords

  • hospitalization costs
  • length of stay
  • pulmonary embolism
  • rivaroxaban
  • warfarin

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Pulmonary Embolism Inpatients Treated With Rivaroxaban Had Shorter Hospital Stays and Lower Costs Compared With Warfarin. / Margolis, Jay M.; Deitelzweig, Steven; Kline, Jeffrey; Tran, Oth; Smith, David M.; Crivera, Concetta; Bookhart, Brahim; Schein, Jeff.

In: Clinical Therapeutics, Vol. 38, No. 11, 01.11.2016, p. 2496-2503.

Research output: Contribution to journalArticle

Margolis, Jay M. ; Deitelzweig, Steven ; Kline, Jeffrey ; Tran, Oth ; Smith, David M. ; Crivera, Concetta ; Bookhart, Brahim ; Schein, Jeff. / Pulmonary Embolism Inpatients Treated With Rivaroxaban Had Shorter Hospital Stays and Lower Costs Compared With Warfarin. In: Clinical Therapeutics. 2016 ; Vol. 38, No. 11. pp. 2496-2503.
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