Economic evaluation of the use of enoxaparin for thromboprophylaxis in acutely ill medical patients

Lloyd, AC; Anderson, PM; Quinlan, DJ; Bearne, A

doi:10.3111/200104099113

Cited by 22 publications

(27 citation statements)

References 27 publications

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“…[37][38][39][40][41] However, the quality of these analyses is moderate at best. First, many of the authors have had fi nancial disclosures with the pharmaceutical industry, and whether these ties infl uence the cost-neutral or cost-saving results of LMWH over LDUH is unclear.…”

Section: Anticoagulant Thromboprophylaxis In Acutely Ill Hospitalizedmentioning

confidence: 99%

Prevention of VTE in Nonsurgical Patients

Falck‐Ytter

Francis

Johanson

et al. 2012

Chest

1,768

485

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Section: Anticoagulant Thromboprophylaxis In Acutely Ill Hospitalizedmentioning

confidence: 99%

Prevention of VTE in Nonsurgical Patients

Falck‐Ytter

Francis

Johanson

et al. 2012

Chest

1,768

485

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“…[98][99][100][101] Pharmacoeconomic data also reveal that LMWH once daily is costeffective in this setting versus LDUH given twice or three times daily. 102,103 Given the clinical data discussed, all hospitalized general medical patients should be assessed for VTE risk factors using both acute medical illnesses and predisposing risk factors and those deemed to be at moderate or high risk should be given thromboprophylaxis with LDUH (preferably 5000 U three times daily) or LMWH (4000 U or more once daily). Patients with myocardial infarction currently receive aggressive antithrombotic regimens and do not need special considerations for venous thromboprophylaxis.…”

Section: Medical Conditionsmentioning

confidence: 99%

Prevention of Venous Thromboembolism

Pini¹,

Spyropoulos²

2006

Semin Thromb Hemost

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Patients with clinical conditions such as surgery, trauma, and acute medical illness have a transiently increased risk of venous thromboembolism and merit consideration for adequate thromboprophylaxis. The choice of an appropriate pharmacologic or physical means of prophylaxis should be made taking into account both the thrombotic and bleeding risk associated with patient-related factors and the type of surgery or other disease state involved. A large number of randomized clinical trials, meta-analyses, and guidelines developed by scientific societies worldwide have addressed this issue and have provided information and recommendations that should be considered carefully. The aim of this review is to provide the practicing physician with a brief updated summary of the subject, stratifying those patients at low thrombotic risk who do not require specific thromboprophylaxis apart from early ambulation, from those at moderate or higher thrombotic risk. Patients at moderate thrombotic risk face a 10 to 20% risk of deep vein thrombosis (DVT) and require prophylaxis with low-dose unfractionated heparin or low molecular weight heparins (LMWHs) at a dosage < 3400 U once daily, or with graduated elastic stockings if their bleeding risk is high. Patients with an expected 20 to 40% DVT rate without prophylaxis are considered at high thrombotic risk and should be treated preferentially with LMWHs at high prophylactic dosage (> 3400 U). Patients undergoing major orthopedic surgery face a DVT rate > 40%, are considered at very high risk of venous thromboembolism, and should be given either LMWHs at high prophylactic dosage, fondaparinux, or vitamin K antagonists--either alone or in association with intermittent pneumatic compression devices.

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“…The study by Pechevis et al [22] for the French health‐care setting yielded an incremental cost‐effectiveness ratio in terms of cost per death avoided, which did not exceed $7376 (¤8102), while our study yielded a figure of ¤1527. Another study by Lloyd et al [23] assessed the cost‐effectiveness of prophylaxis for VTE in acutely ill medical patients in the United Kingdom. The incremental cost‐effectiveness ratio for enoxaparin compared to no prophylaxis was ¤1260 per event avoided, which is higher than the ¤432 in our study.…”

Section: Discussionmentioning

confidence: 99%