Cost-effective prophylaxis against venous thromboembolism after total joint arthroplasty: warfarin versus aspirin
Mostafavi Tabatabaee, R.; Rasouli, M.R.; Maltenfort, M.G.; Parvizi, J.
Journal of Arthroplasty 30(2): 159-164
ISSN/ISBN: 1532-8406 PMID: 25534862 DOI: 10.1016/j.arth.2014.08.018
Although recent guidelines suggest aspirin for venous thromboembolism (VTE) prophylaxis in low risk patients following total hip arthroplasty (THA) and total knee arthroplasty (TKA), there are no cost-effectiveness studies comparing aspirin and warfarin. In a Markov cohort cost-effectiveness analysis, we found that aspirin cost less and saved more quality-adjusted life-years (QALYs) than warfarin in all age groups. Cost per QALY gained by aspirin was $24,506.20 at age of 55 and $47,148.10 at the age of 85 following THA and $15,117.20 and $24,458.10 after TKA, which were greater than warfarin. In patients undergoing THA/TKA without prior VTE, aspirin is more cost-effective prophylactic agent than warfarin. Warfarin might be a better prophylaxis in TKA patients with high probability of VTE and very low probability of bleeding.