Cost-Effectiveness of Dalteparin and Enoxaparin for Preventing Venous Thromboembolism in Patients with Cancer

June 2011, Vol 2, No 3 -


Minneapolis, MN—Patients with cancer receiving anticancer therapy are at risk for recurrent venous thromboembolism (VTE). Prophylactic treatment against such an adverse event is often done with a low-molecular-weight heparin, such as dalteparin (Fragmin), or enoxaparin (Lovenox, Clexane). In previous research, dalteparin was more effective than oral anticoagulants in preventing recurrent VTE.

Results from the new retrospective study called CLOT, using real-world data, show that dalteparin may be more cost-effective than enoxaparin for the prevention of recurrent VTE in patients with cancer.

Using commercial claims data, researchers from Global Health Economics & Outcomes Research, Summit, NJ, identified 12,053 patients with cancer who had a previous VTE event, including deep-vein thrombosis or pulmonary embolism.

A total of 396 patients received dalteparin and 11,657 patients received enoxaparin between January 2004 and December 2008.

The rate of recurrent VTE was significantly (P = .001) lower with dalteparin (2.8%) than enoxaparin (3.7%), whereas the rate of major bleeding did not differ significantly.

The total annual costs associated with VTE were $19,589, which, when multiplied by the rates of recurrent VTE and major bleeding, translated to a total per-patient cost of $589 for those taking dalteparin versus $754 for those taking enoxaparin. This analysis suggests that dalteparin is more costeffective than enoxaparin for VTE prevention in patients with cancer.

The investigators noted that the treatment duration did not mirror that in the 6-month study. “It would appear that patients are initially treated with newer, even more effective, yet more expensive, treatments followed by older, less effective and considerably cheaper treatments,” they observed.