Comparative Effectiveness of Dalteparin and Enoxaparin in a Hospital Setting

Abstract

Purpose: This study compared the effectiveness of a change from enoxaparin to dalteparin for the prophylaxis of patients at risk of venous thromboembolism (VTE). Methods: A retrospective cohort study identified hospitalized patients with VTE risk admitted at Wellmont Health System between August 1, 2008 and July 31, 2009. On February 1, 2009, a therapeutic interchange from enoxaparin to dalteparin occurred. All patient records were reviewed from billing data collected 6 months prior and following conversion. Statistical tests of heterogeneity compared distributions of demography between study cohorts and Cochran tests were used to compare pre- versus postchange in the outcomes. Results: A total of 3557 and 3465 patient discharges were analyzed in the 6 months prior and following the interchange, respectively. Of these discharges, 1870 were administered enoxaparin and 1639 dalteparin. VTE rates were similar between the 2 groups. Data showed no significant difference in-hospital length of stay (LOS), readmittance, and bleeding rates in the populations. The system achieved a $40 788 savings over 6 months following the conversion using approved prophylactic dosing per patient indication. Conclusions: Dalteparin is similarly effective as enoxaparin and an alternative for the prophylaxis of VTE in a hospital setting while providing cost savings.