Cost-effectiveness analysis as a tool to compare two methods of preparing and administering intravenous heparin...

Thirty-six patients who received heparin infusions were prospectively monitored to determine costs involved in preparation and administration of heparin solutions and to determine the most cost-effective heparin concentration. Thirty-five courses of therapy were evaluated. All patients were treated with intravenous (IV) heparin in variable concentrations to allow for delivery of 20 ml/hour of solution (Standard Rate Method). Changes in dosing required preparation of a new solution. The average cost of a course of therapy was $36.62 +/- $23.98. Using a microcomputer, data for these courses of heparin were fitted to ten standard heparin concentration models. The solutions represented standard concentration models obtained from the pharmacy literature. Standard concentrations would allow for decreased preparation time and potential use of discontinued solutions. Of ten different standard concentrations evaluated, three (30,000 units/500 ml, 25,000 units/500 ml, and 25,000 units/250 ml) were found to be cost-effective when compared to the hospital's standard rate method. The potential cost savings of a standard heparin concentration in our institution is approximately $2000 each year.