title: Comparison of cost effectiveness of streptokinase and urokinase in the treatment of deep vein thrombosis.
abstract: This study examines the comparative efficacy, safety, and cost associated with treatment of deep vein thrombosis with streptokinase or urokinase. Sixty patients were analyzed retrospectively, 30 treated with streptokinase and 30 treated with urokinase. Statistically significant greater fibrinogenolysis was noted when streptokinase was used to treat patients with deep venous thrombosis (p = 0.01). The mean decrease in fibrinogen from preinfusion value was 83% in the streptokinase treated group and 61% in the urokinase treated group. Five of 30 (17%) of the streptokinase treated patients experienced major complications. No major complications were seen in the urokinase treated group (p = 0.019). Cost analysis demonstrates that therapy with urokinase was $11.40 per patient more than streptokinase. If complications are not included in the cost analysis, then urokinase becomes only $650 per patient more expensive than streptokinase therapy. These data support that deep vein thrombosis treatment with urokinase is effective, safer and more cost efficient when compared to streptokinase.
authors.affiliation: Cleveland Clinic Foundation, Ohio 44106.
authors.forename: R A
authors.initials: RA
authors.lastname: Graor
authors.forename: J R
authors.initials: JR
authors.lastname: Young
authors.forename: B
authors.initials: B
authors.lastname: Risius
authors.forename: W F
authors.initials: WF
authors.lastname: Ruschhaupt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*; D013924:Thrombophlebitis / Q000097:blood / Q000188:drug therapy* / Q000191:economics; D014568:Urokinase-Type Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D005340:Fibrinogen; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator