Abstract

OLIVEROS, Henry; LOBELO, Rafael  and  MARTINEZ, Fabio. Cost effectiveness analysis of low molecular weight heparines in early anti thrombotic prophilaxis in medical and surgical patients. Acta Med Colomb [online]. 2006, vol.31, n.2, pp.71-82. ISSN 0120-2448.

Objective: to evaluate the cost effectiveness of low molecular weight heparin (LMWH) (Enoxaparin, dalteparin, nadroparin) in the early thrombo prophylaxis of medical and surgical patients. Material and methods: we searched three bibliographic databases from 1990 to 2005 and included studies that were randomized (MEDLINE, EMBASE and CENTRAL) of LMWH which reported the efficacy and safety of each one of the LMWH when the comparison was made during early thrombo-prophylaxis of clinical and surgical patients. The summary of the measures to decrease thrombosis and bleeding risks was obtained. The costs derived from the thromboprophylaxis, bleeding and thrombotic events were estimated according the point of view of the service providing company. Results: 173 studies for enoxaparin were identified, 117 for dalteparin and 110 for nadroparin, and according to the inclusion criteria, 14 enoxaparin, 4 dalteparin and 5 nadroparin studies were chosen from each group. Resume measurements were obtained for bleeding and thrombosis risks for the purpose of staging, according to the kind of pathology and non fractioned heparin control or placebo. The cost effectiveness analysis was carried out comparing each one of the LMWH with the reports obtained from the patients with medical pathology where information about the three LMWH was found. Conclusions: in our health environment, the main cost determinant is established by the price of the medicine, regardless the efficacy of the molecule in the prevention of thrombotic events when they are used in low and medium risk deep vein thrombosis (DVT) groups. Only when the risk is high these molecules would be more cost effective regardless the price of the molecule.

Keywords : randomized-controlled-trial; venous thrombosis; heparin; low molecular weight heparin.

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