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Arixtra or clexane which one is cheaper?






There is 3 type of low molecular weight heparin(LMWH) in malaysian market.
  1. S/C FONDAPARINUX (ARIXTRA) 2.5mg & 7.5mg
  2. S/C ENOXAPARINE (CLEXANE) 20MG & 40MG & 60MG
  3. S/C TINZAPARIN (INNOHEP) 10000IU & 14000IU & 18000IU
    Im not going to explain the MOA or administration. Im going to discuss about the pharmaco-economics of this drugs.Another exclusion in this discussion is Innohep, because s/c innohep not widely use in Malaysian government hospitals and even private settings. A single pre-filled syringe of Clexane 60mg will cost around around RM28-29(not retail price) for a health care facility meanwhile Arixtra 2.5mg will cost RM27-28. May be you can think RM 1 ringgit doest make such big difference? yes! when healthcare facility buying in large quantity. Another factor we need to aware about is mostly Clexane is a twice daily dosing  except in renal impairment meanwhile Arixtra is a daily dosing drug. So the price become double.Another factor we need to consider is HALAL. Clexane not certified as HALAL because there is a element of pig in the contain meanwhile Arixtra fully synthetic and no issue. So need to consider Muslim patient's concern about taking this injection, some don't mind and some not insist to use it. In renal impairment situation use of Clexane always best choice because dose can be adjusted but for Arixtra we can't do that.

   My suggestion about this situation is use Arixtra for muslim patients. Clexane in non-muslim patients and renal impairment patients. In acute situation and we dont posses renal profile of the patient suggest to use Clexane because might worsen patient's kidney situation and play safe.

STILL THINK CLEXANE CHEAP?

Sincerly,
Pharmacist.

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