PMID- 18445118
OWN - NLM
STAT- MEDLINE
DCOM- 20080813
LR  - 20230829
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 6
IP  - 7
DP  - 2008 Jul
TI  - Hospital-based costs associated with venous thromboembolism treatment regimens.
PG  - 1077-86
LID - 10.1111/j.1538-7836.2008.02997.x [doi]
AB  - INTRODUCTION: Venous thromboembolism (VTE) poses a significant health and 
      economic burden in US hospitals. Clinical guidelines for acute VTE treatment 
      recommend antithrombotic therapy (at least 5 days) with low molecular weight 
      heparin (LMWH) or unfractionated heparin (UFH). With upcoming US national 
      performance measures requiring successful implementation of evidence-based 
      therapy, cost considerations for anticoagulant choice are of increasing 
      importance to hospitals. METHODS: This retrospective cohort analysis utilizes 
      discharge records from a large real-world US population (January 2002 to December 
      2006) to provide total, direct, inpatient medical costs associated with LMWH and 
      UFH for acute VTE treatment. Furthermore, for both LMWH and UFH discharges, we 
      compare VTE-related readmission rates at 30 and 90 days after discharge. RESULTS: 
      In total, 57 131 discharges were identified (57.7% LMWH; 42.3% UFH). After 
      adjustment for covariates, including age, severity of illness, and length of 
      stay, total direct medical costs per hospital discharge for UFH were $3476.22 vs. 
      $3056.42 for LMWH (P < 0.0001; difference $420). Costs were significantly higher 
      in the UFH group for most cost categories. Notably, drug acquisition cost was 
      higher for LMWH. LMWH treatment was 12% [odds ratio (OR) 0.876; P < 0.001] and 
      10% (OR 0.895; P = 0.0006) less likely to result in VTE readmission within 30 and 
      90 days, respectively. CONCLUSIONS: This study provides the first large, 
      real-world analysis of the total direct medical costs of treating VTE 
      in-hospital. It confirms that, despite higher drug acquisition costs, LMWH is 
      cost-saving compared with UFH in the inpatient setting, and is associated with a 
      lower VTE readmission rate at 30 and 90 days than is UFH.
FAU - Merli, G
AU  - Merli G
AD  - Jefferson Center for Vascular Diseases, Thomas Jefferson University, 
      Philadelphia, PA, USA. geno.merli@jefferson.edu
FAU - Ferrufino, C
AU  - Ferrufino C
FAU - Lin, J
AU  - Lin J
FAU - Hussein, M
AU  - Hussein M
FAU - Battleman, D
AU  - Battleman D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080701
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/economics/therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - Heparin/economics/therapeutic use
MH  - Heparin, Low-Molecular-Weight/economics/therapeutic use
MH  - *Hospital Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Venous Thromboembolism/drug therapy/*economics
EDAT- 2008/05/01 09:00
MHDA- 2008/08/14 09:00
CRDT- 2008/05/01 09:00
PHST- 2008/05/01 09:00 [pubmed]
PHST- 2008/08/14 09:00 [medline]
PHST- 2008/05/01 09:00 [entrez]
AID - S1538-7836(22)11918-5 [pii]
AID - 10.1111/j.1538-7836.2008.02997.x [doi]
PST - ppublish
SO  - J Thromb Haemost. 2008 Jul;6(7):1077-86. doi: 10.1111/j.1538-7836.2008.02997.x. 
      Epub 2008 Jul 1.