TY - JOUR
T1 - Cost-minimization analysis of low-molecular-weight heparin (dalteparin) compared to unfractionated heparin for inpatient treatment of cancer patients with deep venous thrombosis
AU - Avritscher, Elenir B.C.
AU - Cantor, Scott B.
AU - Shih, Ya Chen T.
AU - Escalante, Carmelita P.
AU - Rivera, Edgardo
AU - Elting, Linda S.
N1 - Funding Information:
Acknowledgements This study was supported in part by a grant from Pharmacia, Inc. The authors wish to thank Charissa D. Higginbotham for her editorial support.
PY - 2004/7
Y1 - 2004/7
N2 - Goals: Low-molecular-weight heparin (LMWH) has shown to be as effective as unfractionated heparin (UFH) in the treatment of deep venous thrombosis (DVT). Although the acquisition cost of LMWH is significantly greater than that of UFH, we hypothesized that once-daily dalteparin, a LMWH, could reduce treatment costs of cancer patients with DVT by eliminating anticoagulation monitoring and shortening hospitalization. Patients and methods: We developed a cost-minimization model by using outcomes and resource utilization data from two retrospective matched cohorts of cancer patients who, between 1994 and 1999, were hospitalized at our comprehensive cancer center for treatment of DVT with either LMWH (n=21) or UFH (n=168). We assumed all LMWHs and UFH to be equally effective. The total costs for the dalteparin strategy and the UFH strategy were calculated in year 2003 U.S. dollars, from the provider's perspective, by multiplying the number of resources used for inpatient treatment of DVT by their unit costs. Results: The mean total cost for inpatient care was $3,383 (95% CI= $2,683-$4,083) for dalteparin and $4,952 (95% CI=$4,718-$5,185) for UFH. Substantial savings resulted from shorter hospitalization among the dalteparin-treated patients (mean 3.19 versus 5.22 days). Sensitivity analysis did not change the conclusion that dalteparin is less expensive than UFH. Conclusions: Savings realized from less anticoagulant monitoring and shorter hospitalization offset the higher acquisition cost of dalteparin. The dalteparin strategy is less expensive than the UFH strategy for the inpatient treatment of DVT among cancer patients.
AB - Goals: Low-molecular-weight heparin (LMWH) has shown to be as effective as unfractionated heparin (UFH) in the treatment of deep venous thrombosis (DVT). Although the acquisition cost of LMWH is significantly greater than that of UFH, we hypothesized that once-daily dalteparin, a LMWH, could reduce treatment costs of cancer patients with DVT by eliminating anticoagulation monitoring and shortening hospitalization. Patients and methods: We developed a cost-minimization model by using outcomes and resource utilization data from two retrospective matched cohorts of cancer patients who, between 1994 and 1999, were hospitalized at our comprehensive cancer center for treatment of DVT with either LMWH (n=21) or UFH (n=168). We assumed all LMWHs and UFH to be equally effective. The total costs for the dalteparin strategy and the UFH strategy were calculated in year 2003 U.S. dollars, from the provider's perspective, by multiplying the number of resources used for inpatient treatment of DVT by their unit costs. Results: The mean total cost for inpatient care was $3,383 (95% CI= $2,683-$4,083) for dalteparin and $4,952 (95% CI=$4,718-$5,185) for UFH. Substantial savings resulted from shorter hospitalization among the dalteparin-treated patients (mean 3.19 versus 5.22 days). Sensitivity analysis did not change the conclusion that dalteparin is less expensive than UFH. Conclusions: Savings realized from less anticoagulant monitoring and shorter hospitalization offset the higher acquisition cost of dalteparin. The dalteparin strategy is less expensive than the UFH strategy for the inpatient treatment of DVT among cancer patients.
KW - Cancer
KW - Cost minimization
KW - Deep venous thrombosis
KW - Low-molecular-weight heparin
KW - Unfractionated heparin
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U2 - 10.1007/s00520-004-0597-2
DO - 10.1007/s00520-004-0597-2
M3 - Article
C2 - 14986076
AN - SCOPUS:3142772677
SN - 0941-4355
VL - 12
SP - 531
EP - 536
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 7
ER -