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Ann Pharm Fr. 2017 Nov;75(6):480-488. doi: 10.1016/j.pharma.2017.06.004. Epub 2017 Aug 14.

[Use of a Delphi survey to assess the hospital economic impact of innovative products: The example of idarucizumab a dabigatran-specific reversal agent].

[Article in French]

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Stratégique santé, 52, boulevard de l'Yerres, 91000 Evry, France.
Service pharmacie, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
Assistance publique-Hôpitaux de Paris, agence générale des équipements et des produits de santé, 75005 Paris, France; Faculté de pharmacie de Paris, institut Droit-et-Santé, Inserm UMR S 1145, université Paris-Descartes, Sorbonne Paris Cité, 75006 Paris, France.
Service pharmacie, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France. Electronic address:



The economic impact of therapeutic innovations on the hospital patient management cannot be easily estimated. The objective of this study is to illustrate the use of a Delphi survey as a support tool to identify the changes following the use of idarucizumab in dabigatran-treated patients with uncontrolled/life-threatening bleeding or who required emergency surgery/urgent procedures.


The Delphi questionnaires have been administrated to 8 emergency physicians or anesthetists from 6 different hospital centers. Following the answers, an economic valorization has been carried out on every parameter on which a consensus was reached (at least 4 answers showing an identical trend). A mean management cost for each etiology with and without the use of idarucizumab has thus been identified.


For gastro-intestinal and other life-threatening bleedings (excepted intracranial bleedings), the total management cost of the hospital stay was respectively 6058 € (-35%) and 6219 € (-34%) following the use of the reversal agent. The hospital management cost for intracranial bleeding is slightly increasing to 9790 € (+3%). The cost of a stay for emergency surgery decreases to 6962€ (-2%).


This study shows a positive economic impact following the use of the dabigatran-specific reversal agent for patients with uncontrolled/life-threatening bleeding excepted in the case of intracranial bleeding. Moreover, it points out that a Delphi survey is an easy way to predict the hospital economic impact of a therapeutic innovation when no other evaluation is possible.


Delphi Survey; Economic impact; Hospital; Hémorragie grave; Hôpital; Impact économique; Life-threatening bleedings; Questionnaire Delphi

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