title: Short-term therapy with enoxaparin or unfractionated heparin for venous thromboembolism in hospitalized patients: utilization study and cost-minimization analysis.
abstract: OBJECTIVE
  To evaluate the direct costs of venous thromboembolism (VTE) treatment with unfractionated heparin (UFH) and low-molecular weight heparin, from the institutional perspective.
  
  
  METHODS
  This is a real-world cohort study that included inpatients treated with UFH or enoxaparin for deep venous thromboembolism or pulmonary embolism in a tertiary public hospital. To estimate medical costs we computed the acquisition costs of drugs, supplies for administration, laboratory tests, and hospitalization cost according to the patient ward.
  
  
  RESULTS
  One hundred sixty-seven patients aged 18 to 92 years were studied (50 treated with UFH and 117 with enoxaparin). The median of days in use of heparin was the same in both groups. Activated partial thromboplastin time was monitored in 98% of patients using UFH and 56.4% using enoxaparin. Nonstatistically significant differences were observed between groups in the number of bleeding events (10.0% and 9.4%; P = 1.00); blood transfusion (2.0% and 2.6%; P = 1.00); death (8.0% and 3.4%; P = 0.24); and recurrent VTE, bleeding, or death (20.0% and 14.5%; P = 0.38). Daily mean cost per patient was US$12.63 ± $4.01 for UFH and US$9.87 ± $2.44 for enoxaparin (P < 0.001). The total costs considering the mean time of use were US$88.39 and US$69.11.
  
  
  CONCLUSIONS
  The treatment of VTE with enoxaparin provided cost savings in a large teaching hospital located in southern Brazil.
authors.affiliation: Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Catia
authors.initials: C
authors.lastname: Argenta
authors.forename: Maria Angélica Pires
authors.initials: MA
authors.lastname: Ferreira
authors.forename: Guilherme Becker
authors.initials: GB
authors.lastname: Sander
authors.forename: Leila Beltrami
authors.initials: LB
authors.lastname: Moreira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D001777:Blood Coagulation / Q000187:drug effects; D001803:Blood Transfusion / Q000191:economics; D001938:Brazil; D016009:Chi-Square Distribution; D017046:Cost Savings; D004334:Drug Administration Schedule; D016527:Drug Costs; D016903:Drug Monitoring / Q000191:economics; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006302:Health Services Research; D006470:Hemorrhage / Q000139:chemically induced / Q000191:economics / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D006493:Heparin