PMID- 14986076
OWN - NLM
STAT- MEDLINE
DCOM- 20041021
LR  - 20181113
IS  - 0941-4355 (Print)
IS  - 0941-4355 (Linking)
VI  - 12
IP  - 7
DP  - 2004 Jul
TI  - Cost-minimization analysis of low-molecular-weight heparin (dalteparin) compared 
      to unfractionated heparin for inpatient treatment of cancer patients with deep 
      venous thrombosis.
PG  - 531-6
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 US dollars 
      (95% CI= $2,683- $4,083) for dalteparin and $4,952 US dollars (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.
FAU - Avritscher, Elenir B C
AU  - Avritscher EB
AD  - Section of Health Services Research, Department of Biostatistics, The University 
      of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard-Unit 196, Houston, 
      TX 77030-4009, USA. ecaramel@mdanderson.org
FAU - Cantor, Scott B
AU  - Cantor SB
FAU - Shih, Ya-Chen T
AU  - Shih YC
FAU - Escalante, Carmelita P
AU  - Escalante CP
FAU - Rivera, Edgardo
AU  - Rivera E
FAU - Elting, Linda S
AU  - Elting LS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20040221
PL  - Germany
TA  - Support Care Cancer
JT  - Supportive care in cancer : official journal of the Multinational Association of 
      Supportive Care in Cancer
JID - 9302957
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*economics/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Dalteparin/*economics/therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/*economics/therapeutic use
MH  - Heparin/*economics/therapeutic use
MH  - Heparin, Low-Molecular-Weight/economics
MH  - Humans
MH  - Inpatients/statistics & numerical data
MH  - Length of Stay/economics
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Time Factors
MH  - Venous Thrombosis/drug therapy/*economics
EDAT- 2004/02/27 05:00
MHDA- 2004/10/22 09:00
CRDT- 2004/02/27 05:00
PHST- 2003/06/03 00:00 [received]
PHST- 2003/12/18 00:00 [accepted]
PHST- 2004/02/27 05:00 [pubmed]
PHST- 2004/10/22 09:00 [medline]
PHST- 2004/02/27 05:00 [entrez]
AID - 10.1007/s00520-004-0597-2 [doi]
PST - ppublish
SO  - Support Care Cancer. 2004 Jul;12(7):531-6. doi: 10.1007/s00520-004-0597-2. Epub 
      2004 Feb 21.