Short-Term Treatment With Unfractionated Heparin or Enoxaparin Among Patients Admitted With Acute Myocardial Infarction in a Tertiary Care Centre – A Cost Minimization Analysis

Objective: To estimate the direct medical cost associated with unfractionated heparin (UFH) and enoxaparin among hospitalized patients with acute myocardial infarction (AMI) in a tertiary care center. Methods: The present cohort study was conducted among hospitalized patients treated with UFH or Enoxaparin for AMI in a tertiary care center. Costs of the drugs, supplies for administration, and costs of laboratory test monitoring were added to calculate the total medical cost. The researchers assumed other costs were equivalent between the two groups. Results: Researchers included 100 patients aged 40–88 years, admitted with AMI, with a mean age of 67.10±10.89 years. Moreover, they treated 66 patients with UFH and 34 with enoxaparin. The mean duration of hospital stay in the UFH group was 4.36±2.3 and was 4.85±2.9 in the enoxaparin group (p=0.126). The mean direct medical cost per day was calculated as INR 435.05±50.002 for UFH and INR 926.03±81.462 for enoxaparin (p=0.166), while the direct medical cost considering the mean duration of use was INR 1897.50±1021.9 and INR 4547.79±2710.6, respectively, in both groups (p=0.000). The cost of laboratory monitoring was INR 677.27±218.94 with UFH and INR 308.82±51.45 with enoxaparin (p=0.000). The total cost, including laboratory monitoring, was INR 2574.77±1211.69 in the UFH group and INR 4856.62±2717.9 in the enoxaparin group. Conclusion: Direct medical costs associated with UFH were lower than those of enoxaparin; hence, short-term treatment with UFH for AMI in hospitalized patients provided cost savings in a tertiary care hospital in South Kerala.