The pharmacoeconomics of surgical thromboprophylaxis

Abstract

As mentioned earlier, patients undergoing surgical procedures, particularly operations such as hip or knee arthroplasty, face an increased risk of thrombotic events, including DVT, PE and major bleeding. There are a range of interventions designed to prevent such complications, ranging from compression stockings through to warfarin and LMWH. While the clinical efficacy of these prophylactic interventions has been widely explored, one of the main issues facing physicians is how to balance the clinical needs of patients with the costs of such therapies in healthcare systems. Several key trials on the cost effectiveness of thromboprophylaxis undergoing elective surgery have been conducted. These trials focus on the treatment of patients in a range of settings in Western Europe and the USA. Although the findings are therefore not directly comparable, they reveal that, despite treatment with LMWHs resulting in higher direct healthcare costs, the subsequent reductions in thromboembolic complications are substantial. This typically leads to low costs per life - or quality-adjusted life-years saved, as well as overall healthcare savings.