Rivaroxaban reduced hospitalization by 1 day in pulmonary embolism cases

In the treatment of pulmonary embolism (PE) in North American patients, rivaroxaban (Xarelto) reduced length of hospital stay by 1 full day compared to conventional dual therapy, according to data presented at the American College of Emergency Physicians scientific assembly, October 14-17, in Seattle.

Investigators analyzed hospitalization and length-of-stay data from the North American subset of patients in the randomized, controlled EINSTEIN-PE trial, which evaluated rivaroxaban versus standard treatment with enoxaparin plus warfarin in more than 4,800 patients with acute symptomatic PE. Patients who received rivaroxaban had a significantly shorter length of stay in the hospital by one day, resulting in an estimated savings of $2,040 per patient.

The current standard of care for PE requires a 2-drug regimen: an injectable anticoagulant followed by long-term treatment with an oral vitamin K antagonist (VKA) such as warfarin.

Researchers sought to uncover potential cost-savings for rivaroxaban, which offer physicians a single-drug approach to deep vein thrombosis (DVT) and PE treatment from the moment of diagnosis through the completion of therapy, without the need for routine blood monitoring.

“Traditional anticoagulant treatment requires ‘bridging’-a transition from the injectable low molecular-weight heparins [LMWHs] to orally administered therapy with a vitamin K antagonist [warfarin], which requires several days to become therapeutic,” said Brahim Bookhart, MBA, MPH, director, Health Economics and Outcomes Research, Janssen Scientific Affairs.

“During this period, patients with PE usually remain in hospital for monitoring,” Dr Bookhart continued. “Hospital stay is the most costly component of treatment for DVT/PE. This simplified approach to treatment may have contributed to physicians’ decision to discharge patients from the hospital earlier than conventional dual therapy, and as evidenced by the latest study findings, the reduction in hospital length of stay has the potential to produce substantial economic savings,” Dr Bookhart said.