[Budget impact analysis of Pradaxa thromboprophylaxis after total hip or total knee replacement]

Venous thromboembolism is a serious disease that can be life-threatening in case of pulmonary embolism or induce major sequelae. Patients undergoing major orthopaedic surgery represent a population at high risk of venous thromboembolism. Recently Pradaxa has demonstrated its efficacy and safety versus enoxaparin in 2 pivotal trials. Beyond these clinical benefits on the treatment duration observed, the budget impact model's objective was to assess, from the French Sickness Funds perspective for retail market, the consequence of the introduction of this new drug on French setting for a theoretical, representative sample of 1,000 patients in each indication. The cost saving estimated by the model was in excess of 36,000 Euros per 1,000 procedures for total hip replacements. A univariate sensitivity analysis showed that the budget impact was robust and remained positive with the utilisation of Pradaxa in all cases tested.