Department of Medicine, University of Calgary, Calgary, Canada.
Clin Appl Thromb Hemost. 2011 Apr;17(2):150-7. doi: 10.1177/1076029610389026. Epub 2010 Dec 15.
The efficacy and safety of low-molecular-weight heparins (LMWHs) versus unfractionated heparin (UFH) has been demonstrated for the prevention of venous thromboembolism (VTE) after acute ischemic stroke. Few data exist regarding the economic impact of LMWHs versus UFH in this population. A decision-analytic model was constructed using clinical information from the Prevention of VTE after Acute Ischemic stroke with LMWH Enoxaparin (PREVAIL) study, and drug costs and mean Centers for Medicare & Medicaid Services event costs. When considering the total cost of events and drugs, enoxaparin was associated with cost-savings of $895 per patient compared with UFH ($2018 vs $2913). Findings were retained within the univariate and multivariate analyses. From a payer perspective, enoxaparin was cost-effective compared with UFH in patients with acute ischemic stroke. The difference was driven by the lower clinical event rates with enoxaparin. Use of enoxaparin may help to reduce the clinical and economic burden of VTE.
低分子肝素（LMWH）与未分级肝素（UFH）在预防急性缺血性脑卒中后静脉血栓栓塞症（VTE）方面的疗效和安全性已得到证实。关于在该人群中 LMWH 与 UFH 的经济影响的数据很少。使用来自预防急性缺血性脑卒中后静脉血栓栓塞症用低分子肝素依诺肝素（PREVAIL）研究的临床信息，以及药物成本和医疗保险和医疗补助服务中心的平均事件成本，构建了决策分析模型。当考虑到事件和药物的总成本时，与 UFH 相比，依诺肝素可使每位患者节省 895 美元的成本（2018 美元比 2913 美元）。在单变量和多变量分析中保留了这些发现。从支付者的角度来看，依诺肝素在急性缺血性脑卒中患者中的成本效益优于 UFH。这一差异是由于依诺肝素的临床事件发生率较低所致。依诺肝素的使用可能有助于减轻 VTE 的临床和经济负担。
