Cost-effectiveness of enoxaparin as thromboprophylaxis in acutelly ill medical patients from the Italian NHS perspective.
OBJECTIVE
To determine the cost-effectiveness of thromboprophylaxis with enoxaparin versus no thromboprophlaxis in patients with acute medical illness in Italy from the NHS perspective.


METHODS
Markov process analysis techniques were used to model the health economic outcomes. Clinical data were derived mainly from the MEDENOX trial, while health care utilization was derived from Delphi panels.


RESULTS
An analysis over the MEDENOX trial period shows that the cost per event avoided is [symbol: see text] 2450.99, while the cost per life saved is [symbol: see text] 8395.89. The lifetime model, which assumes no higher risk for recurrence of VTE and mortality in asymptomatic patients, shows that the use of enoxaparin leads a cost per event avoided of [symbol: see text] 2243.20, and cost per life year gained of [symbol: see text] 605.38. The lifetime model, which assumes a higher risk for recurrence of VTE in asymptomatic patients, shows that enoxaparin is dominant over no thromboprophylaxis.


CONCLUSIONS
The results showed that the favourable clinical benefit of enoxaparin as thromboprophylaxis in patients with acute medical illness, which was observed in the MEDENOX trial, results in a positive health economic benefit on the short-term and long-term in the health care setting of Italy.
Nuijten
Mark J C
MJ
MEDTAP International, Amsterdam.
Berto
Patrizia
P
Kosa
Joseph
J
Nadipelli
Vijay
V
Cimminiello
Claudio
C
Spreafico
Alfredo
A
D000208:Acute Disease; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D017984:Enoxaparin / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D012008:Recurrence; D013923:Thromboembolism / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin