Economics of low-molecular weight heparins

Low-molecular weight heparins (LMWHs) have become attractive alternatives t o standard unfractionated heparin (UFH) for the treatment and prophylaxis o f deep vein thrombosis (DVT), and for the management of acute coronary synd rome (ACS), The economic impact of the use of LMWHs has been studied in ran domized controlled studies, in demonstration projects in managed care insti tutions, and in decision models. These studies provide valuable insight int o the ways LMWHs can be economically attractive despite higher per unit cos ts compared with UFH, For the treatment of DVT,the cost benefit of using LM WHs results primarily from the cost shifting from inpatient to outpatient c are, and might be limited by the eligibility of patients for outpatient man agement. In contrast, the attractiveness of LMWHs for ACS and DVT prophylax is hinges on the increased effectiveness of LMWHs compared with standard UF H.