PMID- 21338468
OWN - NLM
STAT- MEDLINE
DCOM- 20110830
LR  - 20181201
IS  - 1542-4758 (Electronic)
IS  - 1492-7535 (Linking)
VI  - 15
IP  - 2
DP  - 2011 Apr
TI  - Tinzaparin reduces health care resource use for anticoagulation in hemodialysis.
PG  - 273-9
LID - 10.1111/j.1542-4758.2011.00531.x [doi]
AB  - Anticoagulation is required during hemodialysis to prevent thrombus formation 
      within the extracorporeal circuit. The low-molecular-weight heparin tinzaparin is 
      more expensive than unfractionated heparin (UFH) in Canada but more convenient to 
      administer. We conducted a time-and-motion study to test the hypothesis that 
      tinzaparin may reduce nursing time and total health care costs compared with UFH. 
      Data on health care resource use associated with anticoagulation during 
      hemodialysis for chronic renal failure were collected at an academic hospital in 
      Quebec. Nursing time was recorded for 8 nurses performing 16 dialysis sessions 
      for 4 patients receiving tinzaparin and 4 receiving UFH (2 dialysis sessions per 
      patient). Nurses had >/= 1 year of experience supervising hemodialysis. We 
      estimated total annual costs of nursing time and health care resources 
      (anticoagulants, medical supplies, and laboratory testing) associated with 
      anticoagulation. In sensitivity analyses, drug costs were varied +/- 30% of their 
      base-case values. Estimated annual nursing times per patient were 0.8 vs. 11.5 
      hours in the first year and 0.6 vs. 10.2 hours in subsequent years for tinzaparin 
      vs. UFH, respectively. Annual drug costs per patient were CAD 898.56 for 
      tinzaparin and 546.75 for UFH. Estimated total annual costs were CAD 1061.03 vs. 
      1012.71 in the first year and CAD 917.75 vs. 895.23 in subsequent years for 
      tinzaparin vs. UFH, respectively. Use of tinzaparin was cost saving relative to 
      UFH if tinzaparin price was reduced 30%. Most of the price differential between 
      tinzaparin and UFH is offset by substantial time savings to nephrology nurses.
CI  - (c) 2011 The Authors. Hemodialysis International (c) 2011 International Society for 
      Hemodialysis.
FAU - Pettigrew, Martine
AU  - Pettigrew M
AD  - Symbiose Partenariat Strategique Inc., Montreal, Quebec, Canada. 
      mleblanc.hmr@ssss.gouv.qc.ca
FAU - Soltys, George I M
AU  - Soltys GI
FAU - Bell, Robert Z
AU  - Bell RZ
FAU - Daniel, Nicole
AU  - Daniel N
FAU - Davis, Joanne R
AU  - Davis JR
FAU - Senecal, Lynne
AU  - Senecal L
FAU - Leblanc, Martine
AU  - Leblanc M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110222
PL  - Canada
TA  - Hemodial Int
JT  - Hemodialysis international. International Symposium on Home Hemodialysis
JID - 101093910
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 7UQ7X4Y489 (Tinzaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/economics
MH  - Cost-Benefit Analysis
MH  - Economics, Nursing
MH  - Fibrinolytic Agents/administration & dosage/*economics
MH  - Heparin/administration & dosage/economics
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*economics
MH  - Humans
MH  - Nursing/methods
MH  - Renal Dialysis/adverse effects/*economics/*nursing
MH  - Tinzaparin
EDAT- 2011/02/23 06:00
MHDA- 2011/08/31 06:00
CRDT- 2011/02/23 06:00
PHST- 2011/02/23 06:00 [entrez]
PHST- 2011/02/23 06:00 [pubmed]
PHST- 2011/08/31 06:00 [medline]
AID - 10.1111/j.1542-4758.2011.00531.x [doi]
PST - ppublish
SO  - Hemodial Int. 2011 Apr;15(2):273-9. doi: 10.1111/j.1542-4758.2011.00531.x. Epub 
      2011 Feb 22.