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Updated: May 25, 2026
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Anticoagulation prophylaxis in orthopedic surgery: an efficiency frontier approach
Kristen Migliaccio-Walle1, Dale Rublee, Teresa A Simon
1Institute for Clinical and Economic Review, Boston, MA 02114, USA. KMigliaccio@icer-review.org
Postgraduate Medicine
|February 9, 2012
Summary
The efficiency frontier method offers a superior approach for selecting anticoagulants after orthopedic surgery, outperforming traditional cost-effectiveness analysis by incorporating safety and efficacy data for better patient outcomes.
Area of Science:
- Health Economics
- Pharmacoeconomics
- Clinical Decision Making
Background:
- Efficiency frontier methodology enhances policy and decision-making in health economics.
- Elective orthopedic surgery anticoagulation serves as a relevant case study for evaluating economic methodologies.
Purpose of the Study:
- To assess novel oral anticoagulants (NOACs) versus enoxaparin for VTE prevention in orthopedic surgery.
- To compare traditional cost-effectiveness analysis with efficiency frontier methodology.
Main Methods:
- Economic modeling comparing apixaban, rivaroxaban, dabigatran, and enoxaparin.
- Analysis from the UK National Health Service perspective over a 5-year horizon.
- Utilized traditional cost-effectiveness metrics and the efficiency frontier, including embolic and bleeding events.
Main Results:
- Apixaban and rivaroxaban emerged as preferred choices based on efficiency frontier analysis.
- Apixaban showed more bleeding events avoided, while rivaroxaban demonstrated better VTE outcomes.
- Costs ranged from £200,000-£463,000 per 1000 patients over 5 years.
Conclusions:
- Traditional cost-effectiveness analysis omits crucial safety data for anticoagulants.
- The efficiency frontier approach provides comprehensive data for informed treatment choices.
- This methodology facilitates better decision-making by considering all relevant outcomes and costs.
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