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Cheaper blood thinner just as effective, study says

Drug NewsAug 24, 06

Injections of the blood thinner heparin treat blood clots just as effectively as a top-selling version that is many times more expensive, researchers said on Tuesday.

To treat deep vein thrombosis, which appears most often as blood clots in the legs, injections of low-molecular weight heparin such as Sanofi-Aventis’ blockbuster Lovenox and Pfizer’s Fragmin have been increasingly seen as more convenient and effective than original heparin.

The original blood thinner, called unfractionated heparin and derived from pig tissues, is given intravenously in the hospital and patients are closely monitored.

The newer, more expensive version of heparin is extracted from the original and has smaller molecules, meaning it is less likely to bind to a protein in the body and presumably making it more predictable and convenient to use. It is injected just once a day, and can be administered by the patient.

But the study by McMaster University researchers found a weight-adjusted dosage of the original, much-cheaper heparin—a six-day course would cost $37 versus $712 for low-molecular-weight heparin—can be injected twice daily without an expensive hospital stay or in-hospital testing.

“That was the underlying reason why we did the study: it is not necessary to do blood testing,” study author Clive Kearon said in a telephone interview.

Blood clots reappeared in less than 4 percent of 700 patients whether they injected the original heparin or low-molecular weight heparin. The rate of major bleeding was also comparable in the two groups.

“This study will open the possibility of an expanded role for inexpensive, ordinary heparin,” Kearon said, noting that most such studies are sponsored by drug companies that may be less motivated to recommend a treatment that costs less.

The study, which was published in the Journal of the American Medical Association, was funded by The Heart and Stroke Foundation of Ontario.

“If you never do a study funded by a peer-reviewed agency, you’re never going to reduce the cost of therapy,” Kearon said.

The difference in cost of the two blood thinners is not as great in Canada or in Europe, where low-molecular weight heparin is more commonly used.

According to The American Heart Association, deep vein thrombosis occurs in about 2 million Americans a year and an estimated 600,000 of those develop a pulmonary embolism in the



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