Sanofi-Aventis' Lovenox favored by US medics for VTE primary prophylaxis

More than 50% of surveyed US orthopedic surgeons and 70% of surveyed managed care organizations’ (MCOs) pharmacy directors chose enoxaparin (Sanofi-Aventis' Lovenox, generics) as the most effective anticoagulant for venous thromboembolism (VTE) primary prophylaxis following major orthopedic surgery, when compared to other available therapies, according to advisory firm Decision Resources. Enoxaparin is the patient-share-leading parenteral anticoagulant for VTE prophylaxis following orthopedic surgery in the world’s major pharmaceutical markets.

Decision Resources’ analysis of the VTE drug market reveals that surveyed physicians and payers are most satisfied with enoxaparin’s efficacy in preventing deep vein thrombosis and pulmonary embolism but they are least satisfied with its effect on all-cause mortality. The findings also reveal that only 25% of surveyed orthopedic surgeons and 15% of surveyed payers identified GlaxoSmithKline’s Arixtra (fondaparinux) as the most efficacious anticoagulant for VTE prophylaxis. These findings contrast sharply with clinical evidence demonstrating fondaparinux’ superiority over enoxaparin for VTE prophylaxis following major orthopedic surgery.

“In a trial comparing fondaparinux with enoxaparin for VTE prevention after hip fracture surgery, rates of VTE were significantly lower among fondaparinux-treated patients compared to those assigned enoxaparin,” said Decision Resources analyst Matthew Killeen. “The results of our survey highlight an important disconnect between fondaparinux’ clinical effects and physician and payer perception of its efficacy and these findings may help explain the drug’s relatively modest uptake for VTE prophylaxis following major orthopedic surgery,” he added.