American Society of Hirudotherapy

Economic evaluation of desirudin vs heparin in deep vein thrombosis prevention after hip replacement surgery

Comparative study published in Pharmacoeconomics (1998)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Observational studyDrug DevelopmentClinical TrialsLevin LA et al. · Pharmacoeconomics, 1998

Abstract

Deep vein thrombosis is a serious complication of orthopaedic surgery and can lead to pulmonary embolism and long term post-thrombotic syndrome. A simulation model based on both epidemiological data and data from clinical trials was used to compare the long term cost effectiveness of standard prophylaxis with subcutaneous unfractionated heparin with that of desirudin (recombinant hirudin), in patients undergoing elective hip replacement. The analysis, which was performed before the price of desirudin was set, showed that prophylactic treatment with desirudin saved 4.5 life-years per 100 patients treated, compared with unfractionated heparin. Desirudin prophylaxis was dominant up to a total drug cost of 4400 Swedish kronor (SEK) per treatment. The results were robust against changes in the parameters used in several sensitivity analyses. This study showed that prophylactic therapy with desirudin compared with unfractionated heparin was more cost effective and potentially cost saving under a wide range of assumptions concerning the future price of desirudin in preventing deep vein thrombosis following elective hip surgery.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeComparative StudyJournal ArticleResearch Support, Non-U.S. Gov't
Indexed MeSH termsAnticoagulantsArthroplasty, Replacement, HipClinical Trials as TopicCost-Benefit AnalysisHeparinHirudin TherapyHirudinsHumansModels, EconomicRecombinant ProteinsSwedenThrombosis

Summary

Simulation model based on epidemiological data and clinical trials compared long-term cost effectiveness of desirudin vs unfractionated heparin after elective hip replacement; desirudin saved 4.5 life-years per 100 patients.

Why This Matters for Hirudotherapy

This comparative study presents an economic evaluation using a simulation model to analyze the long-term cost-effectiveness of desirudin—a recombinant hirudin—versus standard unfractionated heparin for preventing deep vein thrombosis (DVT) following elective hip replacement. The simulation demonstrated that desirudin prophylaxis saved 4.5 life-years per 100 patients and remained cost-effective or cost-saving under a wide range of pricing assumptions. Because the abstract identifies desirudin as a recombinant hirudin, this study is relevant to ASH by illustrating the clinical and economic value of pharmaceutical agents derived from hirudin in modern perioperative care. However, the study relies entirely on a simulation model based on pre-existing data rather than presenting a new prospective clinical trial.

Citation

Economic evaluation of desirudin vs heparin in deep vein thrombosis prevention after hip replacement surgery.

Levin LA et al. · Pharmacoeconomics, 1998

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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