Cost-Effectiveness of Low-Molecular-Weight Heparins for Deep Venous Thrombosis
Authors: Brendan M. Reilly, Arthur Evans
Journal: Annals of Internal Medicine (2000)

Letters21 March 2000Cost-Effectiveness of Low-Molecular-Weight Heparins for Deep Venous ThrombosisBrendan M. Reilly, MD and Arthur Evans, MD, MPHBrendan M. Reilly, MDCook County Hospital; Chicago, IL 60612 (Reilly)Cook County Hospital; Chicago, IL 60612 (Evans)Search for more papers by this author and Arthur Evans, MD, MPHCook County Hospital; Chicago, IL 60612 (Reilly)Cook County Hospital; Chicago, IL 60612 (Evans)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-6-200003210-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We enjoyed Gould and colleagues' cost-effectiveness analysis of low-molecular-weight heparin (LMWH) for deep venous thrombosis and their meta-analysis (1, 2). However, the conclusion that “LMWHs are highly cost-effective for inpatient management of venous thrombosis” seems overdrawn and misleading.The principal result of their meta-analysis (and the linchpin of the cost-effectiveness analysis) is that “LMWH treatment reduces mortality rates after acute DVT [deep venous thrombosis].” Yet the authors admitted that the mechanism for this reduction is mysterious; it was not due to a reduction in deaths from recurrent thromboembolism or bleeding. If a few days of LMWH treatment ...References1. Gould MK, Dembitzer AD, Sanders GD, Garber AM. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A cost-effectiveness analysis. Ann Intern Med. 1999;130:789-99. LinkGoogle Scholar2. Gould MK, Dembitzer AD, Doyle RL, Hastie TJ, Garber AM. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A meta-analysis of randomized, controlled trials. Ann Intern Med. 1999;130:800-9. LinkGoogle Scholar3. Raschke RA, Reilly BM, Guidry JR, Fontana JR, Srinivas S. The weight-based heparin dosing nomogram compared with a “standard care” nomogram. A randomized, controlled trial. Ann Intern Med. 1993;119:874-81. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Brendan M. Reilly, MD; Arthur Evans, MD, MPHAffiliations: Cook County Hospital; Chicago, IL 60612 (Reilly)Cook County Hospital; Chicago, IL 60612 (Evans) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLow-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis: A Cost-Effectiveness Analysis Michael K. Gould , Anne D. Dembitzer , Gillian D. Sanders , and Alan M. Garber Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis Michael K. Gould , Anne D. Dembitzer , Ramona L. Doyle , Trevor J. Hastie , and Alan M. Garber Cost-Effectiveness of Low-Molecular-Weight Heparins for Deep Venous Thrombosis Michael K. Gould and Alan M. Garber Metrics 21 March 2000Volume 132, Issue 6 Page: 508 Keywords Death rates Deep vein thrombosis Drugs Hemorrhage Heparin Inpatients Low molecular weight heparin Mortality Network analysis Thromboembolism ePublished: 15 August 2000 Issue Published: 21 March 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...