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Low-molecular-weight heparins: Pharmacoeconomic decision modeling based on meta-analysis data

Published online by Cambridge University Press:  29 June 2010

Edmundas Kadusevicius ,
Gabriele Kildonaviciute ,
Birute Varanaviciene  and
Danguole Jankauskiene
Edmundas Kadusevicius
Affiliation:
Kaunas Medical University and Kaunas Medical University Hospital
Gabriele Kildonaviciute
Affiliation:
Kaunas Medical University and Quintiles, JSC
Birute Varanaviciene
Affiliation:
Kaunas Medical University Hospital
Danguole Jankauskiene
Affiliation:
Mykolas Romeris University
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Abstract

Objectives: The aim of this study was to compare efficacy, safety, and consumption of low-molecular-weight heparins with unfractionated heparin, and to develop a pharmacoeconomic decision model based on meta-analysis data.

Methods: Review and meta-analysis were performed of published randomized control trials directly comparing the safety and efficacy of low-molecular-weight heparins (LMWHs)—that is, nadroparin, enoxaparin, and dalteparin—and unfractionated heparin (UFH) was performed by two reviewers using inclusion/exclusion criteria based on the research objectives. The value of fixed effects and random effects odds ratio (95 percent confidence interval) was calculated for each trial for the composite end point. Subsequently, a pharmacoeconomic decision modeling based on reference pricing methodology was implemented.

Results: In comparison to UFH, all LMWHs have independently demonstrated greater safety and effectiveness. None of the LMWHs demonstrated a significant superiority over each other; therefore, the group of LMWHs was interchangeable and suitable for cost minimization analysis and reference price implementation. Being the least expensive option, dalteparin single DDD price was set as the reference. Introduction of reference pricing for LMWHs would decrease the total expenditure on LMWHs of approximately 30 percent and would result in total savings of 1.830–2.070 thousand LTL in the country of Lithuania (approximately 0.8 million USD) per year.

Conclusions: The meta-analysis results of LMWHs could be used to support a policy on reference-based pricing and pharmacoeconomic decision modeling in healthcare institutions, which would allow a decrease in healthcare expenditures.

Keywords

Meta-analysisLow-molecular-weight heparins (LMWHs)Unfractionated heparin (UFH)Reference pricingCost-minimization
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 3 , July 2010 , pp. 272 - 279
Copyright
Copyright © Cambridge University Press 2010

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