ArticleBlood2016
Cost-effectiveness of anticoagulants for suspected heparin-induced thrombocytopenia in the United States.
Article in Blood, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Comparative effectiveness and safety of anticoagulants for the treatment of heparin-induced thrombocytopenia.American journal of hematology · 2021Pooled it
- Efficiency and safety evaluation of prophylaxes for venous thrombosis after gynecological surgery.Medicine · 2020Trial
- Article
- Electronic consultation to improve care outcomes in patients with suspected and confirmed heparin-induced thrombocytopenia.Research and practice in thrombosis and haemostasis · 2024Article
- Efficacy and safety of Agatroban in improving the prognosis of ischemic stroke patients.American journal of translational research · 2023Article
- Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report.Frontiers in medicine · 2023Article
- Cost-effectiveness analysis of alternative anticoagulation in suspected heparin-induced thrombocytopenia.Blood advances · 2022Article
- Thrombolysis and use of argatroban for the treatment of massive pulmonary embolism following anticoagulation failure in a patient with COVID-19.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2020Article
- Two High to Start? Targeting a New Starting Dose for Argatroban Infusions.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2020Article
- Comparison of polyspecific versus IgG specific ELISA in predominately cardiac patients with suspected heparin induced thrombocytopenia.Journal of thrombosis and thrombolysis · 2020Article
- Fondaparinux in heparin-induced thrombocytopenia: A decade's worth of clinical experience.Research and practice in thrombosis and haemostasis · 2019Article
- Pharmacogenetics to prevent heparin-induced thrombocytopenia: what do we know?Pharmacogenomics · 2018Article
- Nonpharmacist Health Care Providers' Knowledge of and Opinions Regarding Medication Costs in Critically Ill Patients.Hospital pharmacy · 2018Article
- Emerging Role of Direct Oral Anticoagulants in the Management of Heparin-Induced Thrombocytopenia.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Review
- ADAMTS13 test and/or PLASMIC clinical score in management of acquired thrombotic thrombocytopenic purpura: a cost-effective analysis.Transfusion · 2017Article
- Apixaban for treatment of confirmed heparin-induced thrombocytopenia: a case report and review of literature.Experimental hematology & oncology · 2017Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
Despite the availability of multiple nonheparin anticoagulants for the treatment of heparin-induced thrombocytopenia (HIT), few data are available comparing the cost-effectiveness of these agents. This analysis is particularly important when considering differences in the risk of adverse effects, routes of administration, requirements for phlebotomy and laboratory monitoring, and overall drug costs. We conducted a cost-effectiveness analysis of argatroban, bivalirudin, and fondaparinux for the treatment of suspected HIT from the institutional perspective. A 3-arm decision-tree model was developed that employs standard practices for anticoagulation monitoring. We incorporated published data on drug efficacy and probability of HIT-related thromboembolism and major bleeding. We considered both institutional costs and average wholesale price (AWP) and performed probabilistic sensitivity analyses (PSA) to address any uncertainty in model parameters. Using institutional costs, fondaparinux prevailed over both argatroban and bivalirudin in terms of cost ($151 vs $1250 and $1466, respectively) and adverse events averted (0.9989 vs 0.9957 and 0.9947, respectively). Results were consistent when AWP was used, with fondaparinux being less expensive ($555 vs $3081 and $2187, respectively) and more effective in terms of adverse events averted (0.9989 vs 0.9957 and 0.9947, respectively). The PSA confirmed our findings using both institutional costs and AWP. In conclusion, fondaparinux subcutaneous injection afforded significant advantages in terms of cost savings and adverse events averted compared with IV argatroban or bivalirudin infusions. Our data strongly suggest potential cost savings with fondaparinux and underscore the critical need for larger clinical studies of fondaparinux in the treatment of suspected HIT.
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