Heparin-induced thrombocytopenia cost-effectiveness of therapy

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Heparin-induced thrombocytopenia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Aric C. Hall, M.D., [3], Shyam Patel [4]

Overview

Cost-effectiveness is an important consideration when treating HIT. This is because alternative anticoagulants (other than heparin) can be quite expensive given their unique mechanisms of action and the costs of drug development. It has been shown that fondaparinux is the most cost-effective treatment for HIT, compared to direct thrombin inhibitors.

Cost-Effectiveness of Therapy

There has been one cost-effective analysis of anticoagulants for HIT. The treatment of HIT involves use of alternative anticoagulants, such as direct thrombin inhibitors. However, there is also data for use of the factor X inhibitor fondaparinux, which is less expensive than direct thrombin inhibitors.[1] Fondaparinux would found to be the most cost-effective agent for treatment of HIT, compared to argatroban or bivalirudin. [1]

Argatroban Bivalirudin Fondaparinux
Cost of administration $411.43 $411.43 $25.40
Average wholesale price $1194.65 (1 vial of 250mg) $753.07 (1 vial of 250mg) $220.34 (1 syringe of 7.5mg)
Total cost for 9 days of therapy $1326 $1562 $164

As novel anticoagulants become FDA-approved and arrive to the market, cost-effective analysis will need to be considered. Note that newer generation medications typically have higher costs than traditional medications.

References

  1. 1.0 1.1 Aljabri A, Huckleberry Y, Karnes JH, Gharaibeh M, Kutbi HI, Raz Y; et al. (2016). "Cost-effectiveness of anticoagulants for suspected heparin-induced thrombocytopenia in the United States". Blood. 128 (26): 3043–3051. doi:10.1182/blood-2016-07-728030. PMID PMID27793877 Check |pmid= value (help).