OBJECTIVE: To determine the cost and cost effectiveness of adding venous thromboembolism (VTE) prophylaxis with enoxaparin, a low-molecular-weight heparin, to standard care for acutely ill, hospitalized medical patients. METHODS: A pharmacoeconomic model was developed to simulate the 6- to 14-day course of enoxaparin prophylaxis evaluated in the MEDENOX trial in a US healthcare setting. Clinical results as reported for the trial were applied to resource use and treatment costs in a US healthcare environment. The model projects hospital length of stay and cost for an acute medical admission from a third-party payer perspective, as well as costs for the course of enoxaparin. RESULTS: VTE prophylaxis with enoxaparin would account for 1.2% to 2.4% of the cost of a hospital admission, with an additional $23 +/- $28 to $99 +/- $122 to complete the course of prophylaxis out of hospital. Incremental cost effectiveness of VTE prophylaxis relative to no prophylaxis ranges from $1249 to $3088 per VTE avoided. Venous thromboembolism prophylaxis appears to be a break-even intervention, with the cost recouped through avoided treatment, if the rate of treated VTE without prophylaxis is at least 3-4%. DISCUSSION AND CONCLUSIONS: The MEDENOX trial demonstrated that prophylaxis with enoxaparin substantially decreases the risk of VTE among acutely ill, hospitalized medical patients. Economic analysis indicates that this protection represents a small increase in current treatment costs. Prophylaxis is cost effective in terms of incremental cost per VTE avoided. Furthermore, there is a reasonable likelihood that the cost of prophylaxis will be offset by avoided future VTE treatment.
RCT Entities:
OBJECTIVE: To determine the cost and cost effectiveness of adding venous thromboembolism (VTE) prophylaxis with enoxaparin, a low-molecular-weight heparin, to standard care for acutely ill, hospitalized medical patients. METHODS: A pharmacoeconomic model was developed to simulate the 6- to 14-day course of enoxaparin prophylaxis evaluated in the MEDENOX trial in a US healthcare setting. Clinical results as reported for the trial were applied to resource use and treatment costs in a US healthcare environment. The model projects hospital length of stay and cost for an acute medical admission from a third-party payer perspective, as well as costs for the course of enoxaparin. RESULTS:VTE prophylaxis with enoxaparin would account for 1.2% to 2.4% of the cost of a hospital admission, with an additional $23 +/- $28 to $99 +/- $122 to complete the course of prophylaxis out of hospital. Incremental cost effectiveness of VTE prophylaxis relative to no prophylaxis ranges from $1249 to $3088 per VTE avoided. Venous thromboembolism prophylaxis appears to be a break-even intervention, with the cost recouped through avoided treatment, if the rate of treated VTE without prophylaxis is at least 3-4%. DISCUSSION AND CONCLUSIONS: The MEDENOX trial demonstrated that prophylaxis with enoxaparin substantially decreases the risk of VTE among acutely ill, hospitalized medical patients. Economic analysis indicates that this protection represents a small increase in current treatment costs. Prophylaxis is cost effective in terms of incremental cost per VTE avoided. Furthermore, there is a reasonable likelihood that the cost of prophylaxis will be offset by avoided future VTE treatment.
Authors: Z Tazi Mezalek; C Nejjari; L Essadouni; M Samkaoui; K Serraj; W Ammouri; N Kanjaa; Z Belkhadir; B Housni; M Awab; M Faroudy; W Bono; S Kabbaj; M Akkaoui; M Barakat; R Rifai; H Charaf; A Aziz; Y Elachhab; A Azzouzi Journal: J Thromb Thrombolysis Date: 2018-07 Impact factor: 2.300
Authors: Peter K Schädlich; Michael Kentsch; Manfred Weber; Wolfgang Kämmerer; Josef Georg Brecht; Vijay Nadipelli; Eduard Huppertz Journal: Pharmacoeconomics Date: 2006 Impact factor: 4.981