Impact of Platelet Functional Assays on the Cost of Treating Suspected Heparin-Induced Thrombocytopenia

Abstract

Objectives: To investigate the potential cost savings of using functional platelet assays to confirm the diagnosis of heparin-induced thrombocytopenia (HIT).

Methods: This was a single-center study conducted in the United States. We performed a retrospective cost of illness analysis of suspected HIT, comparing patients with the serotonin release assay (SRA) ordered as part of their diagnostic evaluation to those who did not. The primary clinical end point was a composite of mortality and major bleed.

Results: A total of 147 patients met the study's inclusion criteria. An SRA was ordered in 53 patients of whom 17% were positive. Overall, SRA use did not reduce the composite primary clinical end point (32.1% vs 33%, P = .911). Also, there was no difference in the total cost of hospital stay (US $84781.1 vs US $78534.4, P = .409) nor in the direct medical costs related to HIT management (US $7473.5 vs US $8402.4, P = .393). Early ordering of the SRA (within 48 hours) was associated with shorter length of stay (20 vs 27 days, P = .029) but without a difference in cost of treatment.

Conclusion: The use of SRA did not reduce the costs or improve clinical outcomes in patients with suspected HIT.

Keywords: cost of illness; direct thrombin inhibitor; heparin; thrombocytopenia; thrombosis.