Fondaparinux for Heparin-Induced Thrombocytopenia

Patients with suspected heparin-induced thrombocytopenia (HIT) are at high risk for thromboembolic events and require anticoagulant therapy. The anticoagulant agents currently available in the U.S. to treat HIT patients are argatroban, bivalirudin, and fondaparinux. Argatroban and bivalirudin are administered intravenously in doses that are adjusted based on laboratory monitoring; fondaparinux is given by subcutaneous injection and does not require monitoring.

To compare the cost-effectiveness of these anticoagulants for patients with suspected HIT, investigators used published reports to determine the probabilities of averting adverse events (venous thromboembolism or upper gastrointestinal bleeding) with each agent. They then formulated a …