[Health care economics evaluation of inpatient treatment of venous thrombosis with unfractionated heparin versus subcutaneous low molecular weight heparin at home]

Abstract

Background: An intravenous course of unfractionated heparin as initial treatment is the standard method to treat venous thromboembolism. Increasing scientific knowledge indicates that subcutaneous low-moleculare-weight heparin is just as effective and save as unfractionated heparin. A possible advantage of low-moleculare-weight heparin is the cost saving potential in minor hospitalisation days. Both therapies will be continued for at least three months with an oral anticoagulative. Because hospitalisation belongs to the cost-intensivest factors in the German health care system the question of a health economic difference between both initial treatments raises.

Method: We transformed published empirical evidences to the German health care system, valued them in a cost analysis for a hypothetical cohort of 100 patients and compared the outcome intertherapeutically.

Result and conclusion: From perspective of sickness insurance fund as cost unit we estimate that a partial in hospital initial treatment with subcutaneous low-moleculare-weight heparin is more cost-effective than a total in-hospital initial treatment with unfractionated heparin.