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Showing record 1 from the 1 matches found. Article Reference No 059766 Author Sculpher M J, Lozano-Ortega G, Sambrook J, Palmer S, Ormanidhi O, Bakhai A, Flather M, Steg G, Mehta S R, Weintraub W. Fondaparinux versus enoxaparin in non-ST-elevation acute coronary Article Title syndromes: short-term cost and long-term cost-effectiveness using data from the Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators (OASIS-5) trial Americal Heart Journal Journal Name 2009 Journal Date 157:845-852 Journal Reference Published in a peer reviewed journal Publication Status Availability Details Correspondence to: Mark J. Sculpher, PhD, Centre for Health Economics, University of York, Heslington, York, YO10 5DD, United Kingdom. E-mail: [email protected]. 2003 First Year Clinical Data 2005 Last Year Clinical Data First Year Cost Data 2003 Last Year Cost Data 2005 2006 Cost Base Year O Source Of Article UK, France, Canada, USA Countries Of Authors Countries Applicable USA Applied study Type Of Article Type Of Econ Eval Cost effectiveness analysis;Cost utility analysis Technology Assessed Pharmaceutical B01A ATC Codes 411; 433; 434; 435; 436; 437; 438 ICD-9 Codes FONDAPARINUX; ENOXAPARIN Drug Names Randomised clinical trial;Judgement;Modelling Prob. of Main Clinical Events Randomised clinical trial;Modelling Quantities of Resources Used 'Ad Hoc' Estimation;Local Standard Prices Prices or Costs of Resources Randomised clinical trial;Modelling Outcomes Values Of Outcomes Previously Published Values Major bleeding rate, death, myocardial infarction, stroke, QualityOutcome Measure Qual Of Life Index Source Of Data Costs Included Costs Discounted Benefits Discounted Sensitivity Tested Quantitatively Reported Study Question Key Results adjusted life years (QALY) Generic;Utility assessment;EQ-5D Incorporated from another study Hospital costs;Direct provider/purchaser costs 3% 3% Sensitivity tested Quantitatively reported Based on a randomized control trial (Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators [OASIS-5]) the aim of the study was to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux (2.5 mg daily) and enoxaparin (1 mg per kg twice daily), for nonûST-elevation acute coronary syndrome. Treatment was administered for a mean of 5 days. The rationale of the study was that in OASIS-5 trial, fondaparinux patients were found to have about half the rate of major bleeding 9 days after randomization and at least as good clinical outcomes (death, myocardial infarction, major bleeding and stroke) after 6 months of follow-up. To undertake the economic evaluation, health care resource use and clinical efficacy data from the trial were incorporated into a cost-effectiveness model as applied to both for the time horizon of the trial (6 months) and over the longer term (life time). A societal perspective was adopted and the setting of the study was secondary care in the United States. The effectiveness results showed that for each type of event over the 180-day follow-up period, fondaparinux is protective compared with enoxaparin, although this is not significant with nonfatal MI. For death, nonfatal MI and nonfatal stroke, increasing age, being male, a history of heart failure, and diabetes increase the event risk. ST depression and high creatinine at baseline increase mortality risk. Increased serum creatinine was the only predictive covariate for bleeds. The 180-day cost analysis indicated that fondaparinux would generate a cost saving of US$547 per patient (95% CI US$207US$924). Sensitivity analysis suggested that savings could vary between US$494 and US$733. As well as mean (expected) costeffectiveness, the probability of each therapy being the least costly and the more cost-effective assuming a cost-effectiveness threshold of US$50,000 per QALY gained was presented using probabilistic sensitivity analysis. Fondaparinux was predicted to generate a $188 saving and 0.04 additional QALYs in the ôaverageö OASIS-5 patient. However, when 180-day cost and clinical results were extrapolated to long-term cost-effectiveness, fondaparinux was dominant (less costly and more effective in terms of quality-adjusted life-years) under most scenarios. The authors concluded that fondaparinux is a more costeffective antithrombotic agent than enoxaparin in nonûST-elevation acute coronary syndrome. This is true across the range of event risks seen in the OASIS-5 trial, which informed the present modelling Patient Group Sponsor Keywords study. The patient group comprised of 20,078 male and female patients with nonûST-elevation acute coronary syndrome. Patients participated in the Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators [OASIS-5] trial. The economic analysis was based on a sub-sample of 759 trial patients. Pharmaceutical industry Coronary Heart Disease;Coronary - Artery Disease;Acute Care;Cost Effectiveness;Cost Effectiveness Analysis (CEA);Cost Utility;Cost Utility Analysis;QALYs;Quality Adjusted Life Years;Thrombolytic Agents - Medications;Thrombosis