Hospital-based costs associated with venous thromboembolism prophylaxis regimens

Abstract

Clinically and economically, venous thromboembolic (VTE) disease represents a significant burden to the US healthcare system. This analysis compares the total direct medical costs associated with VTE prophylaxis with enoxaparin and unfractionated heparin (UFH). Hospital discharge and billing records were extracted from the Premier Perspective database (January 2002-December 2006). The primary outcome was the total direct medical costs for discharges that were at risk of VTE and received enoxaparin or UFH. A total of 894,364 discharge records met the study inclusion criteria, of which 39.4% received enoxaparin and 60.6% received UFH. After adjustment for pre-defined covariates, mean total direct medical costs per discharge for the UFH group were $6,443, $1,080 more than those for the enoxaparin group ($5,363; P < .0001). In conclusion, enoxaparin prophylaxis is a cost-saving therapy, when compared with UFH, for the prevention of VTE in patients with a diverse range of medical conditions conferring VTE risk.

Economic impact of enoxaparin versus unfractionated heparin for venous thromboembolism prophylaxis in patients with acute ischemic stroke: A hospital perspective of the PREVAIL trial

“…Previous studies, using hospital or payer information, have shown that VTE prophylaxis is more cost‐effective compared with no prophylaxis. In terms of the different VTE prophylaxis regimens, enoxaparin represents a more cost‐effective option in comparison with UFH19, 21, 29–32 and also when compared with fondaparinux 21, 33. When comparing the results between different trials, it should be noted that previous analyses were mainly modeled on the Prophylaxis in Medical Patients with Enoxaparin (MEDENOX) study, which was performed in general medical patients and reported a VTE rate of 5.5% 6.…”

“…A recent retrospective analysis of transactional billing records demonstrated that, despite higher mean costs of anticoagulation therapy, the mean, total, adjusted direct hospital costs were lower with LMWH thromboprophylaxis compared with UFH ($7358 vs $8680, respectively; difference $1322; P < 0.001) 21. A previous study by Burleigh and colleagues based on hospital discharge information extracted from both medical and surgical patients, has a sub‐analysis in patients with stroke.…”

“…Thromboprophylaxis has been shown to be a cost‐effective strategy in hospitalized medical patients. Prophylaxis with a LMWH has been shown to be more cost‐effective than UFH in these patients 18–21…”

Anticoagulation in the Surgical Management of Peripheral Arterial Embolic Disease

“…LMWH is an attractive treatment option as it is easily dosed and does not require regular blood tests to monitor levels required with UFH. Not only does this make it more convenient but it also has important cost implications [15,16]. Despite the current evidence supporting the use of LMWH instead of UFH in veno-occlusive conditions there is no current guidance in patients with peripheral arterial embolic disease.…”

The cost of outpatient venous thromboembolism prophylaxis following lower limb injuries

“…7 In 1997, the total cost to the health economy in treating VTE related problems in the United States was estimated to be $1.5 billion/year. 8,9 The total cost of managing VTE in the United Kingdom is over £640 million (€798 million; $1.01 billion) annually. 10 Therefore emphasis must be placed on its prevention.…”