title: Applying scientific criteria to therapeutic interchange: a balanced analysis of low-molecular-weight heparins.
abstract: Under pressure to provide cost-effective healthcare, many healthcare systems have adopted Therapeutic Interchange (TI) programs-the interchange of therapeutically equivalent but chemically unique drugs-to reduce the total cost of therapy without compromising patient care. To be appropriate and feasible, a TI program for any class of drugs must meet certain rigorous criteria and undergo medical, financial, tactical, and legal reviews. Moreover, once a TI program is implemented, a process to monitor its success should be established. Application of the TI criteria to low-molecular-weight heparins (LMWHs) reveals that a blanket TI program for LMWHs does not appear advisable at this time.
authors.affiliation: Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 15261, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Merli
authors.forename: G J
authors.initials: GJ
authors.lastname: Vanscoy
authors.forename: T L
authors.initials: TL
authors.lastname: Rihn
authors.forename: J B
authors.initials: JB
authors.lastname: Groce
authors.forename: W
authors.initials: W
authors.lastname: McCormick
mesh_terms: D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods*; D019317:Evidence-Based Medicine / Q000331:legislation & jurisprudence / Q000592:standards; D017408:Guidelines as Topic; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D006495:Heparin, Low-Molecular-Weight / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D013810:Therapeutic Equivalency
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight