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The Cost‐Effectiveness of Different Management Strategies for Patients on Chronic Warfarin Therapy

OBJECTIVE: To examine the cost‐effectiveness of moving from usual care to more organized management strategies for patients on chronic warfarin therapy. DESIGN: Using information available in the scientific literature, supplemented with data from a large health system and, when necessary, expert opi... Full description

Journal Title: Journal of general internal medicine 2000-01, Vol.15 (1), p.31-37
Main Author: Lafata, Jennifer Elston
Other Authors: Martin, Susan A. , Kaatz, Scott , Ward, Richard E.
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Boston, MA, USA: Blackwell Science Inc
ID: ISSN: 0884-8734
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recordid: cdi_crossref_primary_10_1046_j_1525_1497_2000_01239_x
title: The Cost‐Effectiveness of Different Management Strategies for Patients on Chronic Warfarin Therapy
format: Article
creator:
  • Lafata, Jennifer Elston
  • Martin, Susan A.
  • Kaatz, Scott
  • Ward, Richard E.
subjects:
  • Anticoagulants - economics
  • Anticoagulants - therapeutic use
  • anticoagulation management
  • Biological and medical sciences
  • Blood. Blood coagulation. Reticuloendothelial system
  • Cost-Benefit Analysis
  • cost-effectiveness analysis
  • decision analytic model
  • Decision Trees
  • Drug Monitoring - economics
  • Drug Monitoring - methods
  • Humans
  • International Normalized Ratio
  • Markov Chains
  • Medical sciences
  • Original
  • Original Articles
  • Pharmacology. Drug treatments
  • Sensitivity and Specificity
  • warfarin
  • Warfarin - economics
  • Warfarin - therapeutic use
ispartof: Journal of general internal medicine, 2000-01, Vol.15 (1), p.31-37
description: OBJECTIVE: To examine the cost‐effectiveness of moving from usual care to more organized management strategies for patients on chronic warfarin therapy. DESIGN: Using information available in the scientific literature, supplemented with data from a large health system and, when necessary, expert opinion, we constructed a 5‐year Markov model to evaluate the health and economic outcomes associated with each of three different anticoagulation management approaches: usual care, anticoagulation clinic testing with a capillary monitor, and patient self‐testing with a capillary monitor. PATIENTS: Three hypothetical cohorts of patients beginning long‐term warfarin therapy were used to generate model results. MAIN RESULTS: Model results indicated that moving from usual care to anticoagulation clinic testing would result in a total of 1.7 thromboembolic events and 2.0 hemorrhagic events avoided per 100 patients over 5 years. Another 4.0 thromboembolic events and 0.8 hemorrhagic events would be avoided by moving to patient self‐testing. When direct medical care costs and those incurred by patients and their caregivers in receiving care were considered, patient self‐testing was the most cost‐effective alternative, resulting in an overall cost saving. CONCLUSIONS: Results illustrate the potential health and economic benefits of organized care management approaches and capillary monitors in the management of patients receiving warfarin therapy.
language: eng
source:
identifier: ISSN: 0884-8734
fulltext: no_fulltext
issn:
  • 0884-8734
  • 1525-1497
url: Link


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titleThe Cost‐Effectiveness of Different Management Strategies for Patients on Chronic Warfarin Therapy
creatorLafata, Jennifer Elston ; Martin, Susan A. ; Kaatz, Scott ; Ward, Richard E.
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descriptionOBJECTIVE: To examine the cost‐effectiveness of moving from usual care to more organized management strategies for patients on chronic warfarin therapy. DESIGN: Using information available in the scientific literature, supplemented with data from a large health system and, when necessary, expert opinion, we constructed a 5‐year Markov model to evaluate the health and economic outcomes associated with each of three different anticoagulation management approaches: usual care, anticoagulation clinic testing with a capillary monitor, and patient self‐testing with a capillary monitor. PATIENTS: Three hypothetical cohorts of patients beginning long‐term warfarin therapy were used to generate model results. MAIN RESULTS: Model results indicated that moving from usual care to anticoagulation clinic testing would result in a total of 1.7 thromboembolic events and 2.0 hemorrhagic events avoided per 100 patients over 5 years. Another 4.0 thromboembolic events and 0.8 hemorrhagic events would be avoided by moving to patient self‐testing. When direct medical care costs and those incurred by patients and their caregivers in receiving care were considered, patient self‐testing was the most cost‐effective alternative, resulting in an overall cost saving. CONCLUSIONS: Results illustrate the potential health and economic benefits of organized care management approaches and capillary monitors in the management of patients receiving warfarin therapy.
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subjectAnticoagulants - economics ; Anticoagulants - therapeutic use ; anticoagulation management ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Cost-Benefit Analysis ; cost-effectiveness analysis ; decision analytic model ; Decision Trees ; Drug Monitoring - economics ; Drug Monitoring - methods ; Humans ; International Normalized Ratio ; Markov Chains ; Medical sciences ; Original ; Original Articles ; Pharmacology. Drug treatments ; Sensitivity and Specificity ; warfarin ; Warfarin - economics ; Warfarin - therapeutic use
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descriptionOBJECTIVE: To examine the cost‐effectiveness of moving from usual care to more organized management strategies for patients on chronic warfarin therapy. DESIGN: Using information available in the scientific literature, supplemented with data from a large health system and, when necessary, expert opinion, we constructed a 5‐year Markov model to evaluate the health and economic outcomes associated with each of three different anticoagulation management approaches: usual care, anticoagulation clinic testing with a capillary monitor, and patient self‐testing with a capillary monitor. PATIENTS: Three hypothetical cohorts of patients beginning long‐term warfarin therapy were used to generate model results. MAIN RESULTS: Model results indicated that moving from usual care to anticoagulation clinic testing would result in a total of 1.7 thromboembolic events and 2.0 hemorrhagic events avoided per 100 patients over 5 years. Another 4.0 thromboembolic events and 0.8 hemorrhagic events would be avoided by moving to patient self‐testing. When direct medical care costs and those incurred by patients and their caregivers in receiving care were considered, patient self‐testing was the most cost‐effective alternative, resulting in an overall cost saving. CONCLUSIONS: Results illustrate the potential health and economic benefits of organized care management approaches and capillary monitors in the management of patients receiving warfarin therapy.
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authorLafata, Jennifer Elston ; Martin, Susan A. ; Kaatz, Scott ; Ward, Richard E.
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atitleThe Cost‐Effectiveness of Different Management Strategies for Patients on Chronic Warfarin Therapy
jtitleJournal of general internal medicine
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date2000-01
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notesPresented at the Society of General Internal Medicine 21st annual meeting, Chicago, Il, April 23–25, 1998; Building Bridges IV: Improving the Public's Health Through Research Partnerships, Oakland, Calif, May 7–9, 1998; Association for Health Services Research, Washington, DC, June 21–23, 1998; European Cardiology Conference, Vienna, Austria, August 24–28, 1998; and Anticoagulation Forum's 5th annual conference, Vancouver, BC, May 13–15, 1999.
abstractOBJECTIVE: To examine the cost‐effectiveness of moving from usual care to more organized management strategies for patients on chronic warfarin therapy. DESIGN: Using information available in the scientific literature, supplemented with data from a large health system and, when necessary, expert opinion, we constructed a 5‐year Markov model to evaluate the health and economic outcomes associated with each of three different anticoagulation management approaches: usual care, anticoagulation clinic testing with a capillary monitor, and patient self‐testing with a capillary monitor. PATIENTS: Three hypothetical cohorts of patients beginning long‐term warfarin therapy were used to generate model results. MAIN RESULTS: Model results indicated that moving from usual care to anticoagulation clinic testing would result in a total of 1.7 thromboembolic events and 2.0 hemorrhagic events avoided per 100 patients over 5 years. Another 4.0 thromboembolic events and 0.8 hemorrhagic events would be avoided by moving to patient self‐testing. When direct medical care costs and those incurred by patients and their caregivers in receiving care were considered, patient self‐testing was the most cost‐effective alternative, resulting in an overall cost saving. CONCLUSIONS: Results illustrate the potential health and economic benefits of organized care management approaches and capillary monitors in the management of patients receiving warfarin therapy.
copBoston, MA, USA
pubBlackwell Science Inc
pmid10632831
doi10.1046/j.1525-1497.2000.01239.x
tpages7
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