PMID- 11252546
OWN - NLM
STAT- MEDLINE
DCOM- 20010405
LR  - 20181113
IS  - 1170-7690 (Print)
IS  - 1170-7690 (Linking)
VI  - 19
IP  - 1
DP  - 2001 Jan
TI  - Dermatan sulfate versus unfractionated heparin for the prevention of venous 
      thromboembolism in patients undergoing surgery for cancer. A cost-effectiveness 
      analysis.
PG  - 57-68
AB  - BACKGROUND: In a recent clinical trial, dermatan sulfate was found to be more 
      effective than unfractionated heparin (UFH), but equally well tolerated, for the 
      prevention of deep vein thrombosis (DVT) after major surgery for cancer. 
      OBJECTIVE: To perform a cost-effectiveness analysis of dermatan sulfate versus 
      UFH in this clinical setting. DESIGN AND SETTING: This was a retrospective 
      economic analysis using data from a randomised clinical trial, and was performed 
      from the hospital perspective. METHODS: Clinical event rates were extrapolated 
      from the observed venographic DVT rates, using appropriate assumptions from the 
      scientific literature. The economic effects of switching DVT prophylaxis from UFH 
      to dermatan sulfate and the potential lives saved were assessed by a predictive 
      decision model. RESULTS: The per patient cost, including the burden of residual 
      thromboembolic events and major bleeding complications, was estimated to be 154 
      euros (EUR) for dermatan sulfate and EUR185 for UFH (1998 values). With reference 
      to a potential target population of 60,000 patients/year undergoing surgery for 
      cancer in Italy, the total prophylaxis-associated cost was EUR9,258,000 for 
      dermatan sulfate and EUR11,096,000 for UFH, whereas the potential deaths from 
      prophylaxis failure were 204 and 392, respectively. This represented a saving of 
      EUR1,838,000 and 188 potential lives per year with the dermatan sulfate option. 
      The final costs and effects were mainly sensitive to variations in the rates of 
      DVT and pulmonary embolism, and to the possible need for 1 extra day of 
      hospitalisation because of the earlier preoperative initiation of dermatan 
      sulfate prophylaxis. CONCLUSION: Dermatan sulfate is more cost effective than UFH 
      for the prevention of postoperative venous thromboembolism in patients with 
      cancer. If the hospital stay needs to be prolonged, then the dermatan sulfate 
      option may involve a small additional cost (EUR47) per potential life saved.
FAU - Attanasio, E
AU  - Attanasio E
AD  - Department of Experimental Medicine and Pathology, School of Medicine, University 
      La Sapienza, Rome, Italy. ermanno.attanasio@uniroma1.it
FAU - Russo, P
AU  - Russo P
FAU - Carunchio, G
AU  - Carunchio G
FAU - Caprino, L
AU  - Caprino L
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Anticoagulants)
RN  - 24967-94-0 (Dermatan Sulfate)
RN  - 9005-49-6 (Heparin)
MH  - Adult
MH  - Anticoagulants/*economics/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Decision Trees
MH  - Dermatan Sulfate/*economics/therapeutic use
MH  - Health Care Costs
MH  - Heparin/*economics/therapeutic use
MH  - Humans
MH  - Multicenter Studies as Topic
MH  - Neoplasms/surgery
MH  - Postoperative Complications/*economics/prevention & control
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - Venous Thrombosis/*economics/prevention & control
EDAT- 2001/03/17 10:00
MHDA- 2001/04/06 10:01
CRDT- 2001/03/17 10:00
PHST- 2001/03/17 10:00 [pubmed]
PHST- 2001/04/06 10:01 [medline]
PHST- 2001/03/17 10:00 [entrez]
AID - 10.2165/00019053-200119010-00004 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2001 Jan;19(1):57-68. doi: 10.2165/00019053-200119010-00004.