Healthcare Industry News:  Enoxaparin 


 News Release - August 17, 2009

Real-World Study Showed Cost Savings for VTE Prophylaxis with Enoxaparin Compared with Unfractionated Heparin (UFH)

Prophylaxis with Lovenox(R) (Enoxaparin sodium injection) offered a cost reduction per discharge

BRIDGEWATER, N.J., Aug. 17 (Healthcare Sales & Marketing Network) -- Sanofi-aventis U.S. (EURONEXT: SAN and NYSE: SNY) announced today results of a retrospective real-world cohort study comparing the total direct medical costs of Lovenox® (Enoxaparin sodium injection) or unfractionated heparin (UFH) for the prevention of venous thromboembolism (VTE) among at-risk hospitalized medical and surgical patients in the U.S. The study demonstrated VTE prophylaxis with Enoxaparin was a cost-saving therapy with a statistically significant average reduction of $1,080 per discharge compared to prophylaxis with UFH. These findings were recently published online in the Journal of Thrombosis and Thrombolysis.

"The data are encouraging because they provided insights into the costs of VTE in a large population and assessed overall direct medical costs in the hospital from drug acquisition costs through to, and including hospitalization costs," said Geno Merli, M.D., Director at the Jefferson Center for Vascular Disease, Jefferson Medical College, Philadelphia, PA, and lead investigator of the study. "Evidence from this study found that prevention of VTE among inpatients, using Enoxaparin for prophylaxis, was an effective preventative strategy. These data may be utilized to help guide healthcare professionals toward potentially reducing high healthcare costs in the U.S. associated with this often preventable condition."

VTE encompasses both deep-vein thrombosis (DVT) and pulmonary embolism (PE) which poses a significant clinical and economic burden. Each year, the management costs for dealing with VTE are estimated to be approximately $1.5 billion.(1) These costs occur despite VTE being a largely preventable disease. Failure to prevent an initial VTE episode may result in both healthcare costs for the acute event and additional costs for the longer-term consequences.(2)

About the Study

This large scale U.S. real-world health outcomes study compared the total direct medical costs associated with VTE prophylaxis with Enoxaparin and UFH in the inpatient setting. Enoxaparin, a low molecular weight heparin, and UFH are the two most frequently studied pharmacological VTE prophylaxis options. Hospital discharge and billing records were extracted from the Premier Inc. healthcare alliance Perspective(TM) database (January 2002-December 2006). The primary outcome was the total direct medical costs for discharges that were at risk of VTE and received Enoxaparin or UFH. A total of 894,364 discharge records met the study inclusion criteria, of which 39.4% received Enoxaparin and 60.6% received UFH. The average total direct medical costs per discharge for the UFH group were $6,443 compared to a statistically significant decrease of costs for the Enoxaparin group at $5,363 (P<0.001).

While UFH is less expensive for hospitals to purchase, this study showed that this initial drug acquisition savings did not result in overall savings for hospitals. In fact, the study showed that despite higher drug acquisition costs, inpatient VTE prophylaxis with Enoxaparin was associated with hospital cost savings.

Inclusion criteria included records of patients who were aged greater than or equal to 40 years at index admission; had a complete hospital stay (both an admission and discharge date, and a discharge status other than expired or unknown); had received VTE prophylaxis at any time during their index hospitalization; and had a primary diagnosis of cancer, congestive heart failure, severe infectious disease, lung disease, major orthopedic surgery, or abdominal surgery. Exclusion criteria included records of patients who had an inpatient or outpatient diagnosis of VTE during the 12-month pre-index period; had received an index VTE prophylaxis regimen other than Enoxaparin or UFH; had received more than one class of drug, or a regimen that crossed over multiple classes during the index hospitalization (e.g., patients who started on Enoxaparin and subsequently received UFH); or were discharged with co-morbid conditions that are considered contraindicative to anticoagulant therapy. The costs presented were adjusted to age, severity of illness and length of stay (LOS) and, therefore, provided a reliable estimate of the costs of VTE prophylaxis among a heterogeneous group of hospital inpatients. The study is limited in that it relied on discharge records and so carries the limitations inherent in any observational study.

Financial, editorial and content support for this manuscript was provided by sanofi-aventis U.S. LLC.

About the Premier Perspective(TM) Database

The Premier Inc. healthcare alliance Perspective(TM) database is the most comprehensive clinical, financial and operational comparative database in the U.S. It contains information from hundreds of hospitals and millions of discharges, providing means by which hospitals can benchmark their efforts against other hospitals in an effort to improve quality and reduce costs. The Premier healthcare alliance is more than 2,200 U.S. hospitals and 58,000-plus other healthcare sites working together to improve healthcare quality and affordability. Visit

About Venous Thromboembolism (VTE)

Venous thromboembolism is a general term used to describe the formation of a blood clot (thrombus) that blocks a vein. This may occur in any part of the venous system, but the most common manifestations are deep-vein thrombosis (DVT), usually in the leg, and pulmonary embolism (PE). VTE is also a common complication among acutely ill medical patients who have recently been immobilized, a population of medically-ill patients at particularly high-risk for VTE.

DVT affects up to two million people each year in the U.S. and its primary complication, pulmonary embolism (PE), claims approximately 300,000 lives annually. More people in the U.S. die each year from PE complications than breast cancer and AIDS combined. Acting Surgeon General Steven K. Galson, M.D., M.P.H., issued a Call to Action on September 15, 2008 to reduce the number of cases of DVT and PE in the United States.

About sanofi-aventis

Sanofi-aventis U.S. is an affiliate of sanofi-aventis, a leading global pharmaceutical company that discovers, develops and distributes therapeutic solutions to help improve the lives of patients. Sanofi-aventis is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY ).

(1) Spyropoulos, A., et al. "Management of Acute Proximal Deep Vein Thrombosis." CHEST 122 (2002): 108-114.

(2) Merli, G. et al. "Hospital-based costs associated with venous thromboembolism prophylaxis regimens." Journal Thrombosis Thrombolysis. Published Online July 15, 2009. ttp:// b3m3w0805l46v6r4/fulltext.html

Source: sanofi-aventis

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