Patient cost associated with filling a prescription for extended-duration venous thromboembolism (VTE) prophylaxis following surgery for gynecologic cancer.
OBJECTIVE
The primary purpose of this study was to determine the average patient cost for filling a prescription for extended-duration enoxaparin prophylaxis.


METHODS
Women who underwent major abdominal/pelvic surgery for histologically confirmed gynecologic malignancy were included. Patients who underwent minimally invasive surgery, had benign disease or were on treatment for existing VTE were excluded. Pharmacy resource specialists electronically submitted test prescriptions to verify enoxaparin coverage in the outpatient setting prior to hospital discharge. Patient co-pay information collected included: the number of patients requiring prescription insurance prior authorization, those qualifying for the Lovenox Patient Assistance Program® (PAP) and insurance status.


RESULTS
Three hundred and sixty-four patients were discharged with extended-duration enoxaparin prophylaxis for 28 days between October 2009 and May 2011. The average patient cost to complete 28 days of enoxaparin prophylaxis was $62 (median $21, range $0-1210). Prior authorization was required for 32 patients (10%). Two patients (0.6%) qualified for the Lovenox Patient Assistance Program®. A decrease in the average patient cost from $71 to $52 (median $30 to $10) was observed after generic enoxaparin approval in July 2011.


CONCLUSIONS
Our results show that at least 90% of patients filled their prescription of extended-duration enoxaparin prophylaxis after major abdominal surgery for cancer regardless of cost.
Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. kecain@mdanderson.org
Katherine
K
Cain
Kathleen M
KM
Schmeler
Ginger
G
Langley
Oliver
O
Max
Pedro T
PT
Ramirez
Charles F
CF
Levenback
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000191:economics; D003362:Cost-Benefit Analysis; D017984:Enoxaparin / Q000008:administration & dosage / Q000191:economics*; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood / Q000191:economics* / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D019458:Insurance Coverage; D008875:Middle Aged; D011306:Prescription Fees; D014481:United States; D054556:Venous Thromboembolism / Q000191:economics* / Q000517:prevention & control*; D055815:Young Adult
D000925:Anticoagulants; D017984:Enoxaparin