RHONE-POULENC RORER’s LOVENOX LMWH COST IS $23/DAY

RHONE-POULENC RORER's LOVENOX LMWH COST IS $23/DAY average wholesale price, or $161 for a seven-day course of treatment with the low molecular weight heparin product, RPR said April 13. Lovenox (enoxaparin) was approved March 29 for the prevention of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), following hip replacement surgery ("The Pink Sheet" April 12, T&G-4). There are approximately 250,000 hip replacements performed in the U.S. each year, with an incidence of DVT between 45%-70%. According to RPR, heparins currently are used prophylactically only in approximately "one-third of applicable procedures." A study published in the April 1991 Journal of Surgery found that prophylaxis of DVT and PE "can potentially save 16 deaths per 1,000 patients treated and over $375,000 in health care costs for the same treatment group" or approximately $10,000 per avoided death. Cost to treat a DVT is $2,600 and a PE, $4,758, according to data cited by RPR. Additionally, an RPR Phase III study of 607 hip replacement patients found that those receiving Lovenox were discharged up to two days sooner than patients receiving heparin. By comparison, the cost of other forms of prophylaxis of DVT or PE, such as low-dose warfarin or adjusted-dose heparin, can be higher than LMWH due to required daily, routine blood monitoring, RPR said. Lovenox requires no dosage adjustment for body weight and usually requires no daily blood monitoring. While the standard administration period for Lovenox is seven to 10 days post-surgery, the company said it is assessing the incidence of post-discharge DVT in high-risk patients and is "working on the development of an alternative self-injection device." RPR also is exploring additional indications for enoxaparin.