Cost Effectiveness Analysis In Patients With Heart Valve Prosthesis (HVP)

December 26, 2013 updated by: Gihan Hamdy Elsisi, Pharmacoeconomic Unit, Egypt

Cost Effectiveness Analysis for Combination Of Aspirin And Warfarin Versus Warfarin Alone In Egyptian Patients With Heart Valve Prosthesis

The combined Antiplatelet and Anticoagulant treatment decreased thrombus formation and overall mortality. Also the initiation of an efficacious early anticoagulation protocol is important because of its potential impact on the rate of early thromboembolic complications after mechanical valve implantation. An important question that remains to be answered is whether the combination would be cost effective than Warfarin alone, with a reduction in major bleeding. In addition, the knowledge about its cost-effectiveness has not yet been established in Egypt. The aim of this trial based economic evaluation is to conduct a cost-effectiveness analysis for combination of low-dose Aspirin and Warfarin versus Warfarin alone in prosthetic valve patients from the medical provider perspective specially that a misconception is still existed between the physicians in Egypt that the cost of complications is not worthy so our main aim is to test the cost of complications.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

The measurements will be assessed:

A- Number of patients improved during follow up:

  1. Demographic data
  2. Diagnosis
  3. Laboratory tests (CBC, Prothrombin Time, liver and renal function tests)
  4. Echocardiography profile

B-Costs:

Direct medical costs will be assessed directly from hospital's records and tender lists.

Study Type

Interventional

Enrollment (Anticipated)

300

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Egypt
      • Cairo, Egypt
        • Recruiting
        • Ain Shams University Hospitals
        • Contact:
          • Ahmed Hassouna, MD
          • Phone Number: +201223105271
        • Sub-Investigator:
          • Basma Awad, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

15 years to 50 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Patients operated in Ain Shams University Hospitals for aortic and/ or mitral valve replacement.

Exclusion Criteria:

  • Congenital blood disorders, Hemophilia.
  • Advanced liver disease
  • Advanced renal disease (dialysis patients)
  • Aspirin sensitivity
  • Autoimmune diseases
  • Biological bioprosthesis valves
  • Non-compliant & Drop out patient
  • Pregnant women
  • Caucasians.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Combination
Warfarin tablets adjusted according to international normalized ratio (INR) (2 for Aortic Valve Replacement & 2.5-3 for Mitral Valve Replacement, 2.5-3.5 for Double Valve Replacement) and oral 75 mg Acetyl Salicylic Acid tablets daily long life.
Drug: Warfarin
Other Names:
  • Marevan
Drug: Acetyl Salicylic Acid
Other Names:
  • Aspirin
Active Comparator: Warfarin
Warfarin tablets adjusted according to INR (2 for Aortic Valve Replacement & 2.5-3 for Mitral Valve Replacement, 2.5-3.5 for Double Valve Replacement) and placebo long life.
Drug: Warfarin
Other Names:
  • Marevan
Drug: Placebo (for Aspirin)
Sugar pill manufactured to mimic 75 mg Aspirin

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Valve Thrombosis
Time Frame: one year
one year

Secondary Outcome Measures

Outcome Measure
Time Frame
Major Systemic Embolism,
Time Frame: one year
one year
Non-fatal intracranial hemorrhage
Time Frame: one year
one year
Major extra cranial hemorrhage,
Time Frame: one year
one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Pharmacoeconomic Unit, Egypt

Investigators

  • Principal Investigator: Gihan H Elsisi, Msc, Pharmacoeconomic Unit
  • Study Chair: Manal H Elhamamsy, PhD, Faculty of Pharmacy, Ain Shams University
  • Study Director: Mohamed ME Mazar, PhD, Central Administration for Pharmaceutical Affairs

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2013

Primary Completion (Anticipated)

July 1, 2014

Study Registration Dates

First Submitted

December 20, 2013

First Submitted That Met QC Criteria

December 20, 2013

First Posted (Estimate)

December 27, 2013

Study Record Updates

Last Update Posted (Estimate)

December 30, 2013

Last Update Submitted That Met QC Criteria

December 26, 2013

Last Verified

December 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PEU2013

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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