Reimbursement of enoxaparin for outpatient therapy. Proceedings of regional meetings.
Standard treatment of deep venous thrombosis (DVT) previously required hospitalization so patients could receive continuous intravenous infusion of unfractionated heparin. However, on Dec. 31, 1998, enoxaparin (enoxaparin sodium) became the first low-molecular-weight heparin (LMWH) to receive an indication from the FDA for outpatient treatment of DVT without pulmonary embolism (PE). The manufacturer of enoxaparin, Rhône-Poulenc Rorer (RPR), states that outpatient use of enoxaparin can help managed care organizations (MCOs) and other health care systems to reduce health care costs by curtailing some of the expenses previously associated with hospitalization to treat uncomplicated DVT. To ascertain the extent to which reimbursement policies within managed care might impede patients' access to enoxaparin, RPR conducted 15 regional meetings during the summer of 1999. During these meetings, medical directors and other personnel associated with MCOs provided anecdotal information suggesting that a dominant method of reimbursing enoxaparin for outpatient therapy has yet to emerge in the United States; and that reimbursement methods appear to be divided equally among the pharmacy benefit, the medical benefit, and a "blended" system combining attributes of the pharmacy and medical benefits.
D000553:Ambulatory Care; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use*; D004496:Education, Continuing; D017984:Enoxaparin / Q000191:economics* / Q000627:therapeutic use*; D005569:Formularies as Topic; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007356:Insurance, Pharmaceutical Services; D014481:United States; D020246:Venous Thrombosis / Q000188:drug therapy*
D000925:Anticoagulants; D017984:Enoxaparin