ECONOMIC EVALUATION OF LOW MOLECULAR WEIGHT HEPARIN (LMWH) AND UNFRACTIONATED HEPARIN (UFH) FOR ACUTE MYOCARDIAL INFARCTION: SINGLE CENTER STUDY, PUNE

Vinod K.*, Shraddha D. and Sonia J.

ABSTRACT

Background: Healthcare cost, including the cost of therapy for treatment of cardiac diseases are a growing burden on public domain, the standard care on which public money is spent during hospitalization is a matter of concern. Benefits of UFH in Acute Coronary Syndrome (ACS) have been well-established. However, now extensive variety of newer anticoagulants like low molecular weight heparin, direct thrombin inhibitor and selective factor Xa Inhibitor are available for clinical use. The objective of the study was to evaluate the cost of enoxaparin versus unfractionated heparin in Myocardial infarction. Methods and material: This prospective observational study included patients admitted in ICU and HDU which were divided into three groups. Group 1 received treatment with low molecular weight heparin (LMWH) (n=30), group 2 received treatment with unfractionated heparin (UFH) (n=24) and group 3 received treatment with both LMWH and UFH (n=30). Demographic data & direct cost of pharmacological treatment was collected for each patient. Finally, the total cost for all drugs received by the patients during six months period was calculated. Results: 84 out of 196 patients were included with the primary diagnosis of acute myocardial infarction over the interval of six months. A total of 319 drugs was prescribed in 84 patients and mean number of drugs prescribed per patient were 10±1.9 (range 8-15) in Group-I, 10±1.5 (range 8- 12) in Group-II and 13±2.6 (range 10-19) in Group-III. The average cost of anticoagulants was more in Group III (Rs. 7461 ± 2604.19) as compared group I (Rs.3936 ± 1655.46) and group II (Rs. 409 ± 347.37). Conclusion: For treating acute myocardial infarction in hospitalized patients unfractionated heparin can be initiated and then switching to enoxaparin appears to be cost saving and more beneficial, although cost implications depends on local revascularization practice. For treating acute myocardial infarction in hospitalized patients, enoxaparin is an economical attractive option. The higher acquisition cost of enoxaparin is compensated by reduction in catheterization, revascularization procedures, decreased hospital stay resulting in overall cost-saving.

Keywords: ACS, ICU and HDU.