[Cost-effectiveness analysis of enoxaparin for the prophylaxis of venous thromboembolism in major orthopedic surgery patients].
OBJECTIVE
A retrospective, modeled, cost-effectiveness analysis was conducted with enoxaparin versus non-prophylaxis, tinzaparin, and unfractionated heparin for venous thromboembolic disease in Spanish patients undergoing major orthopedic surgery from the standpoint of the Spanish national health system. Episodes avoided and life-years gained with each treatment were estimated by a meta-analysis of clinical trials.


RESULTS
With enoxaparin fewer thromboembolic episodes and deaths occurred, when compared to the available alternative options. Enoxaparin was the dominant option (lower total cost and equal or greater effectiveness than any alternative option) in comparison with non-prophylaxis, tinzaparin, and unfractionated heparin. A sensitivity analysis confirmed the stability of these results.


CONCLUSIONS
The administration of enoxaparin as a prophylactic treatment for venous thromboembolic disease in patients undergoing hip or knee surgery is a cost-effective intervention in every case, and less expensive than the alternative options used in Spain.
Brosa Riestra
M
M
Area de Investigación Aplicada. GOC Networking. Barcelona. Spain. carlos.rubio@wanadoo.es
Rubio-Terrés
C
C
Nadipelli
V
V
Casado Collado
A
A
Martínez Brotons
F
F
D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017984:Enoxaparin / Q000191:economics* / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000191:economics* / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D000078222:Tinzaparin; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D017984:Enoxaparin; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin; D006493:Heparin
Análisis coste-efectividad de enoxaparina en la proxilaxis de la enfermedad tromboembólica venosa en pacientes sometidos a cirugía mayor ortopédica.