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 recoupled 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.
|Original language||English (US)|
|Number of pages||7|
|Journal||American Journal of Managed Care|
|State||Published - Dec 1 2002|
ASJC Scopus subject areas
- Health(social science)
- Health Professions(all)