Deep vein thrombosis: treatment with enoxaparin or unfractionated heparin cost the same

Clinical bottom line (level 1b)

  1. The costs of treating patients with symptomatic DVT were similar whether once-daily enoxaparin, twice-daily enoxaparin or unfractionated heparin was used.
de Lissovoy et al: Archives of Internal Medicine 2000; 160 : 3160-3165
Expires November 2003

The study

cost-minimisation study
Setting: 39 acute hospitals, USA

randomised controlled trial involving patients with a symptomatic DVT comparing enoxaparin once or twice daily with unfractionated heparin

  • Viewpoint: hospital administration
  • Benefit assessment: hospital stay, hospital readmission
  • Resources and costs: calculated in 1997 US dollars: length of hospital stay, laboratory tests and diagnostic procedures, physician and other healthcare professional encounters, dose and quantity of study medication
  • Sensitivity analysis: A sensitivity analysis was performed varying unit costs by 50% above and below the base line.

    The evidence

    intervention cost
    once-daily enoxaparin $12166
    twice-daily enoxaparin $11558
    unfractionated heparin $11558

    Effect of sensitivity analysis: Sensitivity analysis did not change the results.

    Comments

    1. Though treatment with enoxaparin costs more, patients on it had fewer tests and spent less time in hospital than patients on unfractionated heparin.

    Citation

    1. de Lissovoy G, Yusen RD, Spiro TE, et al: cost for inpatient care of venous thrombosis: a trial of enoxaparin vs standard heparin. Archives of Internal Medicine 2000; 160 : 3160-3165
    Search Terms: from ACP Journal Club
    Contributor: Chris Ball, November 2001
    Reviewer:

    Clinical Question.
    Patient symptomatic DVT
    Intervention or Exposure enoxaparin once or twice daily
    Comparison unfractionated heparin
    Outcome cost of hospital stay
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