Rev. OFIL 2017, 27;3:225-234
Fecha de recepción: 05/09/2016 – Fecha de aceptación: 25/10/2016
Gimeno-Ballester V1,2, Larrodé Leciñena I1,3, Izuel Rami M1, Abad Sazatornil R1
1 Servicio de Farmacia. Hospital Universitario Miguel Servet. Zaragoza (España)
2 Universidad de Granada (España)
3 Universidad de Zaragoza (España)
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Correspondencia:
Vicente Gimeno-Ballester
Hospital Universitario Miguel Servet (Servicio de Farmacia)
Pº Isabel la Católica, 1-3
50009 Zaragoza
Correo electrónico: vgimenob@salud.aragon.es
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SUMMARY
Subject: Evaluate by conducting a meta-analysis network, therapeutic equivalence of low molecular weight heparins for thromboprophylaxis in patients undergoing elective hip replacement surgery and determine the cost effectiveness.
Methodology: A systematic search of randomized clinical trials was conducted and controlled by the low molecular weight heparins marketed in Spain for this indication. A multivariate random effects analysis was performed using Bayesian to synthesize and analyze information consistency. The primary endpoint was selected rate of venous thromboembolism during treatment. A model was made in Excel® to calculate the cost of treatment during hospitalization and outpatient basis by conducting 1,000 Monte Carlo simulations. The model took into account the sale price of the laboratory in inpatient and retail price for outpatient treatment.
Results: 22 clinical trials were included. No significant differences in any of the three variables analyzed were found. no source of inconsistency is detected in either analysis. The low molecular weight heparin presented a lower cost was nadroparin with a cost per patient of €130±20 instead tinzaparin which obtained a higher cost €177±9.
Key Words: Low molecular weight heparine, cost-minimization analysis, meta-analysis, cost effectiveness, review, orthopedic surgery, venous thromboembolism.
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Download PDF: Metaanálisis en red y análisis de minimización de costes del uso de heparinas de bajo peso molecular en cirugía ortopédica