Older Version of Heparin Cheaper, Effective

In the prevention of blood clots in thelegs and lungs, a recent study shows thatthe older, cheaper version of heparin,when given subcutaneously, providesresults as good as the newer, moreexpensive version that is administeredthrough intravenous infusion. Investigatorsreport that the additional costbenefit of the older version is that it doesnot require continuous monitoringthrough the activated partial thromboplastintime (APTT) test. The study included697 patients susceptible to thromboembolismtreated at 6 medical centersin Canada and New Zealand. All patientsreceived heparin (Coumadin) as treatment;70% of patients were treated asoutpatients. Among those patients giventhe older version of heparin, 3.8% hadrecurrent clots, compared with 3.4% ofpatients receiving the newer version oflow-molecular-weight fractionated heparin.The necessity of APTT testingrequired with the intravenous infusionincreases the cost of treatment considerably:a 6-day course of the subcutaneous,older version of heparin wouldcost $37, compared with $712 for thenewer, fractionated heparin. The resultswere published in the August 23/30,2006, issue of the Journal of theAmerican Medical Association.

Ms. Farley is a freelance medicalwriter based in Wakefield, RI.