Economic evaluation of the use of enoxaparin in non-ST-elevation acute coronary syndrome.

This paper reviews the published literature on the costs and benefits of low-molecular-weight heparins (LMWHs) compared with unfractionated heparin (UFH), in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS). Although LMWH has superior efficacy to UFH in NSTE-ACS, it must also provide cost-effectiveness or net-cost savings before its wide use can be approved by healthcare payers. The drug-acquisition costs of LMWH are higher than those of UFH, but economic analyses should also consider the initial medical resource consumption and the downstream costs associated with failed treatment and subsequent care. Based on published economic analyses, the incremental drug costs of LMWH compared with UFH are compensated for by savings in medical-resource costs secondary to reducing ischemic events in NSTE-ACS patients.