Cost-effectiveness of bemiparin in the prevention and treatment of venous thromboembolism.

Venous thromboembolism is a major health problem with substantial morbidity, mortality and related health care costs. Low-molecular-weight heparins (LMWHs) are drugs of first choice in the prophylaxis and treatment of venous thromboembolism. Bemiparin is a new LMWH with a higher antithrombotic activity than other LMWHs at equivalent dosing and a low bleeding tendency. Bemiparin was a dominant strategy over enoxaparin in major orthopedic surgery providing better outcomes and cost savings. Postoperative start of prophylaxis allowed a third of patients scheduled to undergo total knee or hip replacement to be admitted the same day of surgery, thus potentially reducing hospital stay costs. In the acute treatment of deep vein thrombosis, bemiparin was a dominant strategy over unfractionated heparin providing net cost savings and increased quality-adjusted life expectancy compared with unfractionated heparin plus oral anticoagulants. Outpatient management of venous thromboembolism with bemiparin in selected patients resulted in significant cost savings compared with in-patient treatment, while maintaining effectiveness and safety. Bemiparin may be a safer and cost-neutral alternative to oral anticoagulants for long-term treatment (secondary prophylaxis) of venous thromboembolism.