Cost-effectiveness of enoxaparin as thromboprophylaxis in acutely ill medical patients in Spain.
OBJECTIVE
The objective of this study was to determine the cost-effectiveness of thromboprophylaxis with enoxaparin versus no thromboprophylaxis in patients with acute medical illness in Spain from the society 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 currency 432, while the cost per life saved is currency 1527. The cost per event includes all medical resource utilization costs associated with the event. The lifetime model, which assumes no higher risk for recurrence of venous thromboembolism (VTE) and mortality in asymptomatic patients, shows that the use of enoxaparin leads a cost per event avoided of currency 270 and cost per life-year gained of currency 71. If the lifetime model assumes a higher risk for recurrence of VTE in asymptomatic patients, enoxaparin is dominant over no thromboprophylaxis.


CONCLUSIONS
The results showed that the favorable 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 in both the short term and the long term in the health-care setting of Spain.
Nuijten
M J C
MJ
MEDTAP International, Amsterdam, The Netherlands. nuijten@medtap.nl
Villar
F Antoñanzas
FA
Kosa
J
J
Nadipelli
V
V
Rubio-Terrés
C
C
Suarez
C
C
D000208:Acute Disease; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017984:Enoxaparin / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008390:Markov Chains; D012008:Recurrence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013923:Thromboembolism / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*
D000925:Anticoagulants; D017984:Enoxaparin