title: Economic impact of enoxaparin after acute ischemic stroke based on PREVAIL.
abstract: The efficacy and safety of low-molecular-weight heparins (LMWHs) versus unfractionated heparin (UFH) has been demonstrated for the prevention of venous thromboembolism (VTE) after acute ischemic stroke. Few data exist regarding the economic impact of LMWHs versus UFH in this population. A decision-analytic model was constructed using clinical information from the Prevention of VTE after Acute Ischemic stroke with LMWH Enoxaparin (PREVAIL) study, and drug costs and mean Centers for Medicare & Medicaid Services event costs. When considering the total cost of events and drugs, enoxaparin was associated with cost-savings of $895 per patient compared with UFH ($2018 vs $2913). Findings were retained within the univariate and multivariate analyses. From a payer perspective, enoxaparin was cost-effective compared with UFH in patients with acute ischemic stroke. The difference was driven by the lower clinical event rates with enoxaparin. Use of enoxaparin may help to reduce the clinical and economic burden of VTE.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Canada. Graham.Pineo@albertahealthservices.ca
authors.forename: Graham
authors.initials: G
authors.lastname: Pineo
authors.forename: Jay
authors.initials: J
authors.lastname: Lin
authors.forename: Lee
authors.initials: L
authors.lastname: Stern
authors.forename: Tarun
authors.initials: T
authors.lastname: Subrahmanian
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D002545:Brain Ischemia / Q000188:drug therapy*; D002648:Child; D003365:Costs and Cost Analysis; D003658:Decision Making, Computer-Assisted; D017984:Enoxaparin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D008875:Middle Aged; D008954:Models, Biological; D020521:Stroke / Q000188:drug therapy*; D014481:United States; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin