Patient self-management of anticoagulation therapy: a trial-based cost-effectiveness analysis

Sue Jowett, Stirling Bryan, Ellen Murray, Deborah McCahon, James Raftery, F D Richard Hobbs, David Fitzmaurice

Research output: Contribution to journalArticle (Academic Journal)peer-review

46 Citations (Scopus)


Demand for anticoagulation management is increasing due to an expansion of clinical indications for therapy. One possible model of care to meet demand is patient self-management (PSM), beneficial to patients who need control over their condition. This study aimed to determine the cost and cost-effectiveness of PSM of anticoagulation compared with routine clinic-based care for patients receiving long-term anticoagulation. A cost-utility analysis was conducted alongside a randomised controlled trial; 617 patients were recruited and followed up for 12 months. There was no significant difference in mean quality-adjusted life years (QALYs) between groups - after adjusting for baseline, the mean difference in QALYs was 0.009 (95% CI, -0.012 to 0.030). Overall mean healthcare costs in the PSM arm were significantly higher at pounds sterling 417 (CI pounds sterling 394- pounds sterling 442) compared with pounds sterling 122 (CI pounds sterling 103- pounds sterling 144) in the control arm. Therefore, using a formal cost-effectiveness analysis, PSM of anticoagulation does not appear to be cost-effective. However, PSM may have other benefits in relieving pressure on traditional clinic-based care, and the cost-effectiveness of this model of care for some subgroups of anticoagulation patients needs to be explored further.

Original languageEnglish
Pages (from-to)632-9
Number of pages8
JournalBritish Journal of Haematology
Issue number6
Publication statusPublished - Sept 2006


  • Aged
  • Anticoagulants
  • Cost-Benefit Analysis
  • Drug Costs
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Self Administration
  • Treatment Outcome
  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't


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