Adding enoxaparin to intermittent pneumatic compression in postoperative venous thromboembolism prophylaxis: cost-effectiveness analysis results

Background Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT), and pulmonary embolism, is a major global health issue, affecting millions of people. The incidence of VTE has been increasing over time. being a common probable postsurgical complication, VTE shall receive considerable clinician’s attention. The most applied approaches for VTE prophylaxis include two maneuvers: namely, the intermittent pneumatic compression (IPC) application, and low molecular weight heparin specifically, Enoxaparin. Aims The main aim of this study was to determine whether adding an Enoxaparin prophylactic regimen to the IPC use as an adjuvant strategy is more cost-effective than using IPC alone for postsurgical VTE prophylaxis. Patients and methods The cost-effectiveness of two VTE prophylactic strategies, IPC alone, and IPC combined with low molecular weight heparin has been evaluated using a decision tree model. Both deterministic and probabilistic sensitivity analyses were performed to ensure results’ robustness. The deterministic analysis varied individual parameters, while the probabilistic analysis used Monte Carlo simulations to assess overall robustness. Results The base-case analysis revealed an incremental cost of 1372.76 LCU per international ++++ for IPC alone, with an incremental utility of 0.0026 quality adjusted life year. Key influential factors identified were the probability of DVT with IPC alone, DVT probability with combined prophylaxis, and the cost of managing DVT incidents. Conclusion Enoxaparin combined with IPC for postsurgical VTE prophylaxis was found to be cost-effective considering a willingness to pay threshold of 25,363.5 LCU per international ++++ upon the conduction of the Monte Carlo simulation.