Magazine article Drug Topics

New Program Helps You Assess Your DVT Treatment

Magazine article Drug Topics

New Program Helps You Assess Your DVT Treatment

Article excerpt


At Brigham & Women's Hospital, Boston, enoxaparin (Lovenox, Aventis) for deep vein thrombosis (DVT) is the No. 10 pharmaceutical on its drug budget. Since it's such a big-ticket item, it stands to reason the hospital wants to ensure the low molecular weight heparin (LMWH) is used optimally.

Here's where a new tool from Aon Consulting, Wellesley, Mass., can help. The consultants at Aon have developed a modeling system to aid hospitals in evaluating their DVT prevention and treatment practices to see if the care rendered is the best both clinically and financially.

For the hospital to do this analysis itself would involve a great deal of time and effort. "I can't possibly wade through 30,000 admissions on my own and get those types of data," said John Fanikos, R.Ph., MBA, assistant director of pharmacy services at the hospital. Thanks to the Aon DVT program, Brigham can now turn this groundwork over to the consultants there.

Funded by a grant from Aventis, the Aon DVT program was tested about a year ago in two New Jersey hospitals-Morristown Memorial in Morristown and Overlook in Summit. It then expanded to 15 hospitals, which have agreed to take part in 2002, with Brigham being one of them. More hospitals are being sought for participation in 2003.

According to Richard Weinberg, M.D., a consultant at Aon, mindful of how busy hospital managers are, the consulting firm is not requiring them to submit fancy data, just standard information involving their patients' diagnoses, procedures that were performed, and drugs utilized during their stay. After hospitals send Aon their data, the information is analyzed and the results are reported back to the facilities in a user-friendly way.

It is not Aon's intention to tell hospitals what to do with these data or which drugs to use, Weinberg emphasized. "That's strictly their decision." That said, use of the modeling tool has determined that, in some hospitals, it pays to use LMWHs, even though their acquisition cost is higher than that of older technologies, such as unfractionated heparin, warfarin, aspirin, or a combination.

The Aon DVT program takes into account not just a drug's acquisition cost but also the cost of administration and monitoring, along with the impact of the drug on length of stay, prevention of subsequent complications, and overall cost of hospitalization. In many hospitals, "it's actually less expensive in the end to use the more expensive LMWHs because of the prevention of complications and reduction of testing and monitoring," Weinberg pointed out. …

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