Cost Model 1

^{Anticoagulation

Software}

Benefit/Cost Models for Computerised Anticoagulation Care

Model 1

If you allocated a highly competent Health Care Professional to do only Anticoagulant Dosing, the performance would undoubtedly be very good providing a good dosing protocol was applied consistently.

However this is hard to achieve due to contributing factors to be taken into account such as annual leave, sickness, change of job or transfer of staff to other departments within the hospital. So to retain this high level of performance in reality is extremely difficult.

Let us say we assume that we already have good dedicated Anticoagulation Care in place. From the Randomised Study (Ref, Poller et al, The Lancet, vol, 352 no.9139 pages 1505-1509) Dawn AC achieved 20% to 30% better INR control in terms of our algorithm.

In the trial the percentage of INR’s for the computer dosed patients was 15% above range and for the manually dosed patients 17%.

It could therefore be concluded that there is (17-15)/17X100= 11% reduction in the number of times a patient enters the high INR ranges which can lead to increased bleeding opportunity.

Note, most of the gain from the computer system was in preventing low INR’s and so possibly preventing thrombo-embolic events.

This would equate to:

Item
Number of Patients	1000
Complication Rate ( 2.7 major bleeds per 100 patient years and 0.6 fatal bleeds per 100 patient years – say overall 3 incidents per 100 patient years) - 3/100 X1000 (Ref, Rosendaal , Journal of Thrombosis and Thrombolysis ISSN0929-5305 Vol 2, No 4 page 265 to 269 Management of Anticoagulant Therapy: The Dutch Experience. Note: The Dutch have one of the best managed thrombosis services in the world !!	30
Using Dawn AC say we reduce the complication rate by say 10%	3
Average cost of Major Incident (conservative estimate)	$20,000
New total saving per annum	$60000

Cost of running Dawn AC	$17000
Approx. Pay back period of Dawn AC Computer system $17000/60000 X 12 months – say round up to four months	Approx. Four Months

“We Really Care"

“Dawn AC is an easy to use, adaptable, powerful, and comprehensive PC based Anticoagulation Software System. It covers the complete oral anticoagulation life cycle with Induction and Maintenance Modules “

“Lancet Nov 7th 1998, Multi-centred Randomised Trial using Dawn AC shows computer aided dosage leads to INR control 20 to 30% better than medical experts”