What is new in Thromboprophylaxis?
Cost-Effectiveness of Thromboprophylaxis with two different low molecular weigh heparins? Enoxaparin vs Fondaparinux!
presented in CHEST 2008, the annual meeting of the American College of Chest Physicians.

Enoxaparin discharges had a mean total direct medical cost of $9,755 compared with $12,683 for fondaparinux discharges, for a difference of $2,928 per patient, Dr. Merli reported. After adjusting for patient and hospital characteristics, the costs associated with enoxaparin were $6,479 compared with $6,658 with fondaparinux, for a difference of $179.The cost of anticoagulant therapy was also lower for enoxaparin discharges than for fondaparinux discharges, at $130 and $163, respectively."The total adjusted medical cost savings per patient was $442 with enoxaparin compared with fondaparinux," Dr. Merli stated. "This is a significant savings, considering the number of patients treated each year for VTE prophylaxis."
"The annual cost of VTE prophylaxis is around $1.5 billion." in USA says Dr Merli.

It would be too primitive to talk about the annual cost of VTE prophylaxis in a big country like India or China based on the ACCP guide lines.In the ENDORSE study we noted that 50% of the hospitalized ( Acute care) would be requiring some form thromboprophylaxis. One can imagine that type calculations would be mind boggling for the indian pharmaceutical industry. In our country many are still of the opinion that very few can chemical thromboprophylaxis and in some situations the doctors are still hesitant to consider the chemical thromboprophylaxis. Injection Heparin ( UFH) is still used by majority when they think it is necessary due to the cost of the low molecular weight heparins. In India LMWH is produced by one or two companies but they are not able to compete with the international brands in many angles. The awareness for the Venous thromboembolism increased in the last 10 years but there is lot more to be done by the Indian doctors and medical companies in this direction.

Pinjala R K. Nov'08