Shorter Hospital Stays and Lower Costs for Rivaroxaban Compared With Warfarin for Venous Thrombosis Admissions Interview with:
Truven Health AnalyticsJay Margolis, PharmD
Sr. Research Scientist
Truven Health What is the background for this study? What are the main findings?

Response: Vitamin K antagonists (VKAs), most commonly warfarin, had been the only orally available anticoagulants available for the last 60 or so years. While highly effective, use of these agents was often problematic due to their narrow therapeutic index, need for routine coagulation monitoring, and interactions with food and other drugs. Recently introduced new oral anticoagulants (NOACs), particularly rivaroxaban, had been shown in clinical trials to provide comparable efficacy to the VKAs without the need for routine coagulation monitoring. There have been few studies outside of clinical trials showing benefits that translate to real-world populations.

In our study using real-world data from a large sample of geographically and demographically diverse US hospitals, patients hospitalized for incident venous thromboembolisms (VTE) initiating oral anticoagulant treatment with rivaroxaban had significantly shorter hospital stays and lower hospitalization costs compared with warfarin-treated patients. What should readers take away from your report?

Response: The shorter hospitalizations and attendant lower costs found for rivaroxaban in clinical trials were found in our study of real-world clinical practice settings across the US. This study provides clinicians with real-world evidence of the potential to decrease their patient’s time in the hospital and lower hospital costs using the newer oral anticoagulants when appropriate for treating their VTE patients. What recommendations do you have for future research as a result of this study?

Response: This study was limited to the VTE hospitalizations. Comparative studies investigating the impact of rivaroxaban compared with VKAs in the community outpatient setting could provide further valuable information for clinicians and patients. Is there anything else you would like to add?

The following statement is from the study’s sponsor, Janssen Scientific Affairs, LLC:

“Growing research in NVAF demonstrates the value that XARELTO® (rivaroxaban) brings to hospitals, doctors and patients. While the cost of XARELTO® may be higher than older anticoagulants, such as warfarin, it is offset by reduced healthcare resource utilization consistently observed in studies, which continually show a greater overall cost savings associated with XARELTO® over the standard of care.” Thank you for your contribution to the community.

Shorter Hospital Stays and Lower Costs for Rivaroxaban Compared With Warfarin for Venous Thrombosis Admissions
Jay M. Margolis, Steven Deitelzweig, Jeffrey Kline, Oth Tran, David M. Smith,Brahim Bookhart, Concetta Crivera, and Jeff Schein
J Am Heart Assoc. 2016;5:e003788, originally published October 6, 2016,doi:10.1161/JAHA.116.003788

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on October 27, 2016 by Marie Benz MD FAAD