Pharmacy World and Science

, Volume 26, Issue 4, pp 214–220 | Cite as

Economic evaluation of enoxaparin for the prevention of venous thromboembolism in acutely ill medical patients

  • Robin OffordEmail author
  • Adam C. Lloyd
  • Pippa Anderson
  • Andy Bearne


Method: We used a previously described economic model created in the context of the UK National Health Service and applied it to St. Thomas’ Hospital, London. A clinical review to determine the number of medical admissions that would require thromboprophylaxis at St. Thomas’ Hospital, based on the inclusion criteria of a medical thromboprophylaxis trial (MEDENOX), was conducted. Costs and effectiveness were determined, based on the provision of thromboprophylaxis to 2000 medical patients.

Results: Comparing treatment with low-molecular-weight heparin (enoxaparin, 40 mg once daily), unfractionated heparin (5000 IU twice daily), or no prophylaxis, the highest cost of thromboprophylaxis was associated with unfractionated heparin (£199,000=€306,000), compared with enoxaparin (£198,000=€305,000) or no prophylaxis (£176,000=€271,000). The model suggested that enoxaparin thromboprophylaxis would result in fewer thromboembolic-related events. Using sensitivity analysis, incorporating certain St. Thomas’-specific costs showed enoxaparin compared with unfractionated heparin or no thromboprophylaxis was cost saving. The cost savings of £65,000 (=€100,000) and £31,000 (=€48,000) respectively are based on maximum uptake of thromboprophylaxis.

Conclusions: The graded implementation of enoxaparin thromboprophylaxis over a four-year period would require funding redistribution. The funding Health Authority would save overall but St. Thomas’ would require an increase in drug expenditure across the clinical directorates of £35,000 (= €54,000) after 4 years.

Acutely ill medical patients Cost saving Economic evaluation Enoxaparin Hospital pharmacy Low-molecular-weight heparin MEDENOX Thromboprophylaxis Unfractionated heparin United kingdom 


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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Robin Offord
    • 1
    • 1
    Email author
  • Adam C. Lloyd
    • 2
  • Pippa Anderson
    • 2
  • Andy Bearne
    • 3
  1. 1.Guy’s and St. Thomas’ Hospital TrustLondonUK
  2. 2.Fourth Hurdle Consulting Ltd.LondonUK
  3. 3.Outcomes ResearchAventis PharmaWest MallingUK

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