Year 2007 Vol. 15 No 3

MODERN DIAGNOSTICS AND THERAPY

GOLUBEV S.A.

OPTIMAL CHOICE PROBLEM OF A LOW MOLECULAR WEIGHT HEPARIN IN SURGICAL PRACTICE: THE CLINICAL AND PHARMACOECONOMIC CRITERIA

In view of insufficient standardization, availability and rationality of low molecular weight heparins (LMWH) preparations usage as medicines for anticoagulant prevention and therapy in general surgery practice, the first in the domestic literature algorithm of physicians’ thinking for determining the drug choice within this pharmaco-therapeutic group for prevention and treatment of venous thromboembolism is suggested and grounded. In the basis of the developed approaches, the principle of clinical equivalence of different LMWH for such indications along with the results of the pharmacoecononmic analysis of cost minimization is used. In conclusion, it is postulated that dalteparin preparations (Fragmin) are pharmacoeconomically preferable in the current realities of the health care system and the pharmaceutical market of the Republic of Belarus.

Keywords: low molecular weight heparins, venous thromboembolism, rational pharmacotherapy, choice of drugs, pharmacoeconomics.
p. 83 - 90 of the original issue
References
  1. Hirsh, J. Heparin and low-molecular-weight heparin: the seventh ACCP conference on antithrombotic and thrombolytic therapy / J. Hirsh, R. Raschke // Chest. – 2004. – Vol. 126. – P. 188-203.
  2. Guidelines on the use and monitoring of heparin / T. Baglin [et al.] // Brit. J. Haematol. – 2006. – Vol. 133. – P.19-34.
  3. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians / V. Snow [et al.] // Ann. Intern. Med. – 2007. – Vol. 146. – P. 204-210.
  4. Голубев, С. А. Фармакоэкономические и фармакоэпидемиологические аспекты применения низкомолекулярных гепаринов в Республике Беларусь / С. А. Голубев // Актуальные вопросы флебологии: материалы респ. науч.-практ. rонф., Витебск, 30 марта 2007 г. / Витебский гос. мед. ун-т; редкол.: А.П.Солодков [и др.]. – Витебск, 2007. – С. 145-147.
  5. Sjoqvist, F. The past, present and future of clinical pharmacology / F. Sjoqvist // Eur. J. Clin. Pharmacol. – 1999. – Vol. 55. – P. 553 – 557.
  6. Голубев, С. А. Основы практической фармакоэкономики / С. А. Голубев; под ред. Д. Мэлоун. – Минск: Минсктиппроект, 2004. – 244 с.
  7. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery / P. Mismetti [et al.] // British J. of Surgery. – 2001. – Vol. 88. – P. 913 – 930.
  8. Профилактика послеоперационных венозных тромбоэмболических осложнений низкомолекулярным гепарином: инструкция по применению / Мин.-во здравоох. Респ. Беларусь – № 87-0603. – Минск, 2003. – 8 с.
Contacts | ©Vitebsk State Medical University, 2007-2023