{"id":45790,"date":"2014-11-03T06:04:19","date_gmt":"2014-11-03T11:04:19","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=45790"},"modified":"2014-11-03T06:04:19","modified_gmt":"2014-11-03T11:04:19","slug":"economic-study-finds-vte-prophylaxis-with-low-molecular-weight-heparin-cost-effective","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/11\/03\/economic-study-finds-vte-prophylaxis-with-low-molecular-weight-heparin-cost-effective\/","title":{"rendered":"Economic Study Finds VTE Prophylaxis with Low-Molecular-Weight Heparin Cost Effective"},"content":{"rendered":"<p>Critically ill patients in the hospital are at high risk for developing venous thromboembolism (VTE). The 2011\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1014475\">PROTECT trial<\/a>\u00a0compared the two most common drug strategies used to prevent VTE\u00a0\u2014 unfractionated heparin (UFH) and dalteparin, a low-molecular-weight heparin (LMWH)\u00a0\u2014\u00a0 and found no difference between the two groups in the primary endpoint of the trial, leg deep-vein thrombosis.<\/p>\n<p>But PROTECT did turn up a significant reduction in the dalteparin group in the important secondary endpoints of pulmonary embolism (PE) and heparin-induced thrombocytopenia (HIT).\u00a0Now a prespecified economic analysis of PROTECT, <a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleID=1921813&amp;utm_source=Silverchair%20Information%20Systems&amp;utm_medium=email&amp;utm_campaign=JAMA%3AOnlineFirst11%2F01%2F2014\">published in\u00a0<em>JAMA<\/em><\/a>, indicates that use of LMWH, though it is more expensive than UFH, may lead to lower hospital costs due to the reduction in PE and HIT.<\/p>\n<p>Hospital costs per patient patient were $39,508 in the LMWH group and \u00a0$40,805 in the UFH group. The cost effectiveness of LMWH remained significant even after assuming large increases in the cost of dalteparin or reductions in the cost of UFH. The results were applicable to both higher-spending and lower-spending health care systems. LMWH was both more effective and less costly in 78% of the simulations performed by the PROTECT investigators.<\/p>\n<p>\u201cThese findings are important for the care of critically ill patients because they provide a cost-minimization rationale that complements clinical effectiveness knowledge from PROTECT. For example, if an ICU with 1,000 medical-surgical admissions per year uses UFH instead of LMWH for prevention of VTE, the annual incremental cost may be between $1,000,000 to $1,500,000 with similar or worse clinical outcomes, despite the individual drug cost of UFH being $4 to $5 less per day,\u201d the authors wrote.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Critically ill patients in the hospital are at high risk for developing venous thromboembolism (VTE). The 2011\u00a0PROTECT trial\u00a0compared the two most common drug strategies used to prevent VTE\u00a0\u2014 unfractionated heparin (UFH) and dalteparin, a low-molecular-weight heparin (LMWH)\u00a0\u2014\u00a0 and found no difference between the two groups in the primary endpoint of the trial, leg deep-vein thrombosis. [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[495,1,7,16],"tags":[745,348,221,1191,631,748],"class_list":["post-45790","post","type-post","status-publish","format-standard","hentry","category-anticoagulation-2","category-general","category-prevention","category-vascular","tag-dalteparin","tag-heparin","tag-low-molecular-weight-heparin","tag-pe","tag-thromboprophylaxis","tag-vte"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/45790","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=45790"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/45790\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=45790"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=45790"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=45790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}