PMID- 12403638
OWN - NLM
STAT- MEDLINE
DCOM- 20030110
LR  - 20220330
IS  - 1170-7690 (Print)
IS  - 1170-7690 (Linking)
VI  - 20
IP  - 14
DP  - 2002
TI  - Cost-effectiveness analysis of enoxaparin versus unfractionated heparin in the 
      secondary prevention of acute coronary syndrome.
PG  - 979-87
AB  - BACKGROUND: The Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave 
      Coronary Events (ESSENCE) and Thrombolysis in Myocardial Infarction (TIMI) 11B 
      studies revealed that enoxaparin reduced the incidence of death, myocardial 
      reinfarction and recurrent angina in patients with acute coronary syndrome (ACS) 
      compared with unfractionated heparin (UFH). OBJECTIVE: To perform a 
      pharmacoeconomic analysis to evaluate the cost effectiveness of treatment with 
      enoxaparin compared with UFH in Spanish patients with ACS. DESIGN AND SETTING: 
      Retrospective cost-effectiveness analysis using data and costs from Spanish 
      sources, conducted from the perspective of the National Health System. PATIENTS, 
      INTERVENTIONS AND OUTCOMES MEASURES: The study was based on the results of the 
      ESSENCE and TIMI 11B clinical trials, which included more than 7,000 patients 
      with ACS treated with enoxaparin or UFH. The main variables studied were the 
      success rate, expressed as patients with no complications (reinfarction, unstable 
      angina or death), and the decrease in the utilisation of healthcare resources 
      (revascularisation procedures and hospitalisation). RESULTS: The base-case 
      results of the analysis showed superior efficacy and lower total treatment and 
      follow-up costs with enoxaparin compared with UFH. The total savings in direct 
      health costs per patient with enoxaparin ranged between 448 and 659 euros (time 
      horizons of 1 month and 1 year, respectively) [2001 values]. The sensitivity 
      analysis results confirmed the advantage of enoxaparin in all cases, except in 
      one scenario: when simultaneously using all the minimum values of the confidence 
      interval for absolute risk reduction (ARR) in the utilisation of health 
      resources. CONCLUSIONS: This study suggests that enoxaparin is a more effective 
      and less expensive treatment option than UFH in secondary prevention of patients 
      with ACS in Spain, confirming the results obtained in other pharmacoeconomic 
      analyses performed in the UK, USA, France and Canada.
FAU - Brosa, Max
AU  - Brosa M
AD  - Applied Research Unit, Gestio and Organitzacio and Comunicacio, S.A., Barcelona, 
      Spain.
FAU - Rubio-Terres, Carlos
AU  - Rubio-Terres C
FAU - Farr, Ibrahim
AU  - Farr I
FAU - Nadipelli, Vijay
AU  - Nadipelli V
FAU - Froufe, Jenaro
AU  - Froufe J
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  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
MH  - Acute Disease
MH  - Angioplasty, Balloon, Coronary/economics
MH  - Anticoagulants/*economics/therapeutic use
MH  - Coronary Artery Bypass/economics
MH  - Coronary Disease/*economics/*prevention & control/therapy
MH  - Coronary Thrombosis/*economics/*prevention & control
MH  - Cost-Benefit Analysis
MH  - Enoxaparin/economics/therapeutic use
MH  - Heparin/*economics/therapeutic use
MH  - Hospital Costs
MH  - Humans
MH  - Models, Economic
MH  - Randomized Controlled Trials as Topic
MH  - Spain
EDAT- 2002/10/31 04:00
MHDA- 2003/01/11 04:00
CRDT- 2002/10/31 04:00
PHST- 2002/10/31 04:00 [pubmed]
PHST- 2003/01/11 04:00 [medline]
PHST- 2002/10/31 04:00 [entrez]
AID - 201403 [pii]
AID - 10.2165/00019053-200220140-00003 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2002;20(14):979-87. doi: 10.2165/00019053-200220140-00003.