At the 2016 American Society of Hematology (ASH) Annual Meeting, researchers from Janssen and Bayer presented data showing that cancer patients treated with Xarelto(rivaroxaban) for blood clots had significantly fewer emergency room (ER) visits and lower healthcare costs at start of therapy vs. patients given standard treatment.
Currently, the standard of care for treating cancer-associated thrombosis is low-molecular weight heparin (LMWH). The analysis evaluated Xarelto in cancer-associated thrombosis; economic and real-world data were also presented supporting the overall safety and efficacy of Xarelto in this patient population. The start of anticoagulation therapy was classified as one of the following: an ER visit, a second return outpatient visit on the same day, a single outpatient visit, or a telephone call.
Data from the analysis showed that fewer patients required an ER visit to initiate treatment with Xarelto compared to LMWH, indicating significant changes in practice and cost savings. For the first 6 months, there were similar rates of patients sent to the ER to begin anticoagulation between the two groups (71% Xarelto vs. 63% LMWH).
After 6 months, a significant decrease was seen in patients starting Xarelto in the ER from 71% at baseline to 42% at 1 year (P=0.008) and 32% at 18 months (P=0.0001); this decrease was attributed to clinicians becoming more familiar with rivaroxaban. After 1 year, 18% of patients who were prescribed Xarelto were managed via telephone call typically following an outpatient visit.
Significant cost savings were also noted for patients treated with Xarelto, which was attributed mainly to the decrease in ER visits.
Xarelto, a factor Xa inhibitor, is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; to treat deep vein thrombosis (DVT), pulmonary embolism (PE); to reduce the risk of recurrence of DVT, PE following 6 months treatment for DVT, PE; and for the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery.