Using Thrombophilia Testing to Determine Anticoagulation Duration in Pediatric Thrombosis is not Cost-Effective - 07/08/11
, Kenneth J. Smith, MD, MSc c
Reprint requests: Dr Sarah H. O’Brien, The Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205.Résumé |
Objective |
To address the cost-effectiveness of thrombophilia testing and treatment strategies among children with a first episode of thrombosis.
Study design |
A 2-year Markov model was developed to evaluate the cost-utility of 3 strategies: (1) no testing, anticoagulate for 3 months, (2) no testing, anticoagulate for 6 months, and (3) testing, anticoagulate 3 or 6 months, based on results. We performed a literature search to estimate clinical probabilities and obtained quality-of-life and cost data from published sources.
Results |
Total costs per patient were $7900 for no test, treat for 3 months; $8900 for test, treat based on results; and $12 100 for no test, treat for 6 months. Three months of treatment without testing was the least expensive strategy and also the most effective (1.74 quality-adjusted life-years) by 0.01 to 0.03 quality-adjusted life-years. Cost-utility ratios were sensitive to variation in hospitalization and medication costs, but 3 months, no testing, always remained the preferred choice.
Conclusions |
Universal thrombophilia testing after a first episode of thrombosis is not cost-effective when used solely to determine anticoagulation duration. Therefore, a full panel of thrombophilia studies does not need to be an automatic response at the time of any deep venous thrombosis diagnoses.
Le texte complet de cet article est disponible en PDF.Mots-clés : DVT, QALY
Plan
| Presented in abstract form at the 2007 American Society of Hematology Annual Meeting. Supported by an American Society of Hematology Fellow Scholar Award. The authors declare no conflicts of interest. |
Vol 155 - N° 1
P. 100-104 - juillet 2009 Retour au numéro
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