Hospital budget implications of substituting dabigatran for warfarin in an anticoagulation service.

Julie K Atay, Karen Fiumara, Gregory Piazza, John Fanikos, Samuel Z Goldhaber

Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 2012;18(2):181-4

PMID: 21873358

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Abstract

The aim of our study was to assess hospital budget implications of substituting dabigatran for warfarin in patients enrolled in a large anticoagulation service. The study population was identified using criteria from randomized controlled trials of dabigatran. We obtained labor costs ($483 per patient) from the hospital's anticoagulation service budget, laboratory costs of international normalized ratio (INR) tests ($267 per patient), and wholesale costs of warfarin 5 mg tablets ($31 per patient) and dabigatran 150 mg capsules ($2464 per patient). A total of 1774 (93.5%) of 1898 patients were eligible to substitute dabigatran for warfarin. The annual projected hospital expense for anticoagulation with dabigatran was $4,371,136, attributable to drug cost alone. The annual projected cost of warfarin management was $1,385,494. This was comprised of $856,842 for labor, $473,658 for INR testing, and $54,994 for the drug cost of warfarin. Substitution will result in increased expense due to drug cost.

Address: Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

DOI: 10.1177/1076029611416642

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MeSH Terms: Anticoagulants, Atrial Fibrillation, Benzimidazoles, Boston, Budgets, Cost Savings, Cost-Benefit Analysis, Dabigatran, Drug Costs, Hospital Costs, Hospitals, University, Humans, International Normalized Ratio, Laboratories, Hospital, Personnel, Hospital, Quality-Adjusted Life Years, Salaries and Fringe Benefits, Stroke, Thrombophilia, Venous Thromboembolism, Warfarin, beta-Alanine