I would have thought that most of the Lovenox usage took place in hospitals where payment of the hospital depended more on DRG's or set payment per procedure in agreements with the third party payers.
For Lovenox, a set payment per medical procedure is the exception rather than the rule. When there is a set payment per procedure, it pertains mainly to the vial formulation of Lovenox for infusion rather than the prefilled-syringe formulation for subcutaneous injection. The vial formulation of Lovenox represents only 1% of total Lovenox use in the US.