Economic Evaluation of Point-of-Care Monitoring Devices for Long-Term Oral Anticoagulation Therapy

55 Pages Posted: 11 Jun 2007

See all articles by Allan G. Brown

Allan G. Brown

Canadian Agency for Drugs and Technologies in Health (CADTH)

Phil Wells

The Ottawa Health Research Institute (OHRI)

Jim Jaffey

The Ottawa Health Research Institute (OHRI)

Lynda McGahan

Canadian Agency for Drugs and Technologies in Health (CADTH)

Man-Chiu Poon

University of Calgary

Karen Cimon

Canadian Agency for Drugs and Technologies in Health (CADTH)

Kaitryn Campbell

McMaster University

Date Written: February 2007

Abstract

Rationale: New technology has made it possible for patients on long-term oral anticoagulation therapy (OAT) to be monitored with portable devices, sometimes in their own homes, rather than having to go to a hospital or laboratory to provide blood by venipuncture. The devices have been on the market for the last decade. Those who administer funds for anticoagulation programs need to know how POC devices compare in cost effectiveness with standard laboratory tests.

Objectives: The objective of this report is to assess the cost effectiveness of POC monitoring devices for long-term OAT.

Methodology: We did a cost effectiveness analysis in a Canadian context using a decision analytic Markov model. We evaluated the two devices available in Canada: CoaguChek® from Roche Diagnostics and ProTime® from the International Technidyne Corporation, from both a societal and a health care payer perspective. We compared standard care to POC use in two settings: anticoagulation clinics and patient self-testing. Probablistic sensitivity analysis was conducted.

Results: The study found that from a publicly funded health care perspective, including nursing home costs, using POC monitors in anticoagulation clinics was cost saving compared to conventional therapy. Using the health care perspective and comparing patient self-testing using POCs with conventional therapy, the cost per additional QALY gained with CoaguChek® is $57,595. (ProTime® was not available in Canada for self-testing at the time our analysis was done.) When a societal perspective is adopted and travel and time costs to patients and their caregivers are included, patient self-testing with CoaguChek® is cost saving.

Conclusions: From a publicly funded health care perspective, and including nursing-home costs, using CoaguChek® or ProTime® in anticoagulation clinics is cost saving relative to conventional testing. Patient self-testing with CoaguChek® is not cost saving from a health provider perspective. But from a societal perspective patient self-testing may be cost effective when patient and care-giver time and travel costs are considered.

Keywords: economic evaluation, anticoagulation therapy, health policy

Suggested Citation

Brown, Allan G. and Wells, Phil and Jaffey, Jim and McGahan, Lynda and Poon, Man-Chiu and Cimon, Karen and Campbell, Kaitryn, Economic Evaluation of Point-of-Care Monitoring Devices for Long-Term Oral Anticoagulation Therapy (February 2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=992909 or http://dx.doi.org/10.2139/ssrn.992909

Allan G. Brown (Contact Author)

Canadian Agency for Drugs and Technologies in Health (CADTH) ( email )

600-865 Carling Avenue
Ottawa, Ontario K1S 5S8
Canada

Phil Wells

The Ottawa Health Research Institute (OHRI) ( email )

725 Parkdale Avenue
Ottawa, Ontario K1Y 4E9
Canada

Jim Jaffey

The Ottawa Health Research Institute (OHRI) ( email )

725 Parkdale Avenue
Ottawa, Ontario K1Y 4E9
Canada

Lynda McGahan

Canadian Agency for Drugs and Technologies in Health (CADTH) ( email )

600-865 Carling Avenue
Ottawa, Ontario K1S 5S8
Canada

Man-Chiu Poon

University of Calgary ( email )

University Drive
Calgary, Alberta T2N 1N4
Canada

Karen Cimon

Canadian Agency for Drugs and Technologies in Health (CADTH) ( email )

600-865 Carling Avenue
Ottawa, Ontario K1S 5S8
Canada

Kaitryn Campbell

McMaster University ( email )

1280 Main Street West
Hamilton, Ontario L8S 4M4
Canada

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
112
Abstract Views
2,125
rank
351,435
PlumX Metrics