ECONOMIC-EVALUATION OF THE USE OF NADROPARIN CALCIUM IN THE PROPHYLAXIS OF DEEP-VEIN THROMBOSIS AND PULMONARY-EMBOLISM IN SURGICAL PATIENTSIN ITALY

The objective of this study was to compare the costs, from the perspec tive of the payer, of using nadroparin calcium, a low-molecular-weight heparin, instead of unfractionated heparin in the prophylaxis of veno us thromboembolism in patients undergoing orthopaedic surgery or major general surgery in Italy. The methods used were based on a published meta-analysis and a survey of clinical practice. We constructed a mode l of the prophylaxis and management of venous thromboembolism in Italy . Resource use associated with individual events was estimated on the basis of the clinical survey. Unit costs, not available from published sources, were taken from charges made by hospitals and from direct ob servation. A sensitivity analysis was conducted to examine whether the results were robust to changes in key variables. In the base case, co mpared with unfractionated heparin, prophylaxis with nadroparin calciu m reduced the expected costs of managing thromboembolism by 267 226 It alian lire (L, 1994 values; $US1 = L1600 approx.) per patient undergoi ng orthopaedic surgery, and by L45 588 per patient undergoing major ge neral surgery. Therefore, switching from unfractionated heparin to nad roparin calcium in these patients offers the possibility of significan t cost savings to the Italian healthcare system.