The cost-effectiveness of low-molecular-weight heparin vs unfractionated heparin in general and orthopaedic surgery: an analysis for the German healthcare system.
BACKGROUND
Studies over the last years provided empirical evidence that low-molecular weight heparins (LMWH) have advantages over unfractionated heparin (UFH) as post-operative thromboprophylactic agents. A detailed perspective economic evaluation for Germany is not available.


METHODS
A deterministic decision-tree analysis was developed to estimate the main cost-relevant pathophysiological events: deep vein thrombosis (DTV), pulmonary embolism (PE) and major bleeding complications (BC) in general and orthopaedic surgery. The specific costs were analysed, summed up and put into relation with saved lifeyears from the perspective of society, third party payer and hospital management. The robustness of these results were substantiated by a detailed sensitivity analysis.


RESULTS
LMWH avoids pathophysiological events, saves costs and lifeyears in general and orthopaedic surgery from all perspectives.


CONCLUSIONS
The use of LMWH as post-operative thromboprophylactic agents is more cost-effective than UFH in Germany.
Szucs
T D
TD
Centre of Pharmacoeconomics, Institute of Pharmacological Sciences, University of Milan, via Balzaretti, 9, Milan, 20133, Italy.
Schramm
W
W
D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D005343:Fibrinolytic Agents / Q000737:chemistry / Q000191:economics*; D013502:General Surgery / Q000191:economics*; D005858:Germany; D006493:Heparin / Q000737:chemistry / Q000191:economics*; D006801:Humans; D008970:Molecular Weight; D009985:Orthopedics / Q000191:economics*; D011182:Postoperative Care / Q000191:economics; D012189:Retrospective Studies
D005343:Fibrinolytic Agents; D006493:Heparin