PMID- 15230364
OWN - NLM
STAT- MEDLINE
DCOM- 20040907
LR  - 20191111
IS  - 0928-1231 (Print)
IS  - 0928-1231 (Linking)
VI  - 26
IP  - 3
DP  - 2004 Jun
TI  - An economic evaluation of the costs and benefits of heparin rationalisation in a 
      hospital pharmacy.
PG  - 160-8
AB  - AIM: To estimate the costs and benefits for a UK hospital pharmacy of stocking a 
      single low molecular weight heparin (LMWH), enoxaparin, compared to stocking 
      unfractionated heparin (UFH) and stocking both UFH and multiple different LMWHs. 
      METHODS: A decision-tree model was developed which considered the use of heparins 
      for five indications: prophylaxis against venous thromboembolism (VTE) in major 
      orthopaedic surgery; VTE prophylaxis in major general surgery; VTE prophylaxis in 
      acute medical inpatients; treatment of diagnosed VTE; and anticoagulation for 
      patients with unstable angina and non-ST-elevation myocardial infarction 
      (UA/NSTEMI). Previously published cost-effectiveness analyses for each indication 
      were combined into a single model and updated to 2002 prices. The number of 
      patients given heparin in each indication was estimated from the pharmacy records 
      of a large UK teaching hospital. The model estimated the use of drugs, staff 
      time, clinical events and resource use resulting from anti-coagulation. Costs 
      were estimated from the perspective of the hospital and the UK National Health 
      Service. RESULTS: Total annual cost was estimated to be pounds sterling 3.2 m 
      (single LMWH), pounds sterling 4.4 m (UFH only) and pounds sterling 3.7 m 
      (multiple heparins). The largest expected cost savings from using a single LMWH 
      compared to UFH only resulted from reduced hospital stay for DVT treatment, 
      reduced revascularisation in UA/NSTEMI and fewer VTE events in orthopaedic 
      surgery. Expected cost savings from using a single LMWH compared to multiple 
      heparins were more modest CONCLUSION: Sub-optimal choice of anticoagulants may 
      result in substantial excess costs elsewhere in the hospital.
FAU - Reeves, Penny
AU  - Reeves P
AD  - Fourth Hurdle Consulting Ltd, 2 Fisher Street, Holborn, London WC1R 4QA, UK. 
      PennyReeves@FourthHurdle.com
FAU - Cooke, Jonathan
AU  - Cooke J
FAU - Lloyd, Adam
AU  - Lloyd A
FAU - Hutchings, Adam
AU  - Hutchings A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Pharm World Sci
JT  - Pharmacy world & science : PWS
JID - 9307352
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*economics/therapeutic use
MH  - Costs and Cost Analysis
MH  - Decision Trees
MH  - Drug Costs
MH  - Enoxaparin/*economics
MH  - Heparin/*economics/therapeutic use
MH  - Heparin, Low-Molecular-Weight/*economics/therapeutic use
MH  - Humans
MH  - Intraoperative Complications/economics/epidemiology/prevention & control
MH  - Inventories, Hospital
MH  - Length of Stay
MH  - Models, Economic
MH  - Orthopedic Procedures/adverse effects
MH  - Pharmacy Service, Hospital/*economics
MH  - State Medicine
MH  - Thromboembolism/economics/epidemiology/prevention & control
MH  - United Kingdom
EDAT- 2004/07/03 05:00
MHDA- 2004/09/08 05:00
CRDT- 2004/07/03 05:00
PHST- 2004/07/03 05:00 [pubmed]
PHST- 2004/09/08 05:00 [medline]
PHST- 2004/07/03 05:00 [entrez]
AID - 10.1023/b:phar.0000026804.25975.be [doi]
PST - ppublish
SO  - Pharm World Sci. 2004 Jun;26(3):160-8. doi: 10.1023/b:phar.0000026804.25975.be.