Applying scientific criteria to therapeutic interchange: a balanced analysis of low-molecular-weight heparins.
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.
Merli
G J
GJ
Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 15261, USA.
Vanscoy
G J
GJ
Rihn
T L
TL
Groce
J B
JB
McCormick
W
W
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
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight