Nonheparin Anticoagulants for Heparin-Induced Thrombocytopenia

To the Editor: Kelton et al. (Feb. 21 issue) 1 recommend fondaparinux for the management of heparin-induced thrombocytopenia in patients with normal renal function because of its ease of use and familiarity, but it has another advantage as well: cost. At our institution, 10 days of treatment with fondaparinux at a dose of 7.5 mg per day costs $400. A 10-day infusion of argatroban costs approximately $7,440, plus an estimated $800 in laboratory costs and the indirect cost of pharmacist supervision, which in sum costs at least $7,840 more than fondaparinux. The costs of different treatment options are particularly relevant when . . .