however, warfarin isn’t widely used in the hospital setting, so this isn’t much of a business opportunity.
Dew,
I'm glad you brought this up.. Yes, Warafin is not used widely in the hospital setting; mostly in conjunction with Lovenox for DVT treatment (so patients can remain on coumadin for 30 days after a DVT) bridging a patient on who is on coumadin with lovenox pre and post surgery...
Something to keep in mind however is that those bridging patients are important in the retail setting as well.. Patients fill a script to take lovenox at home before surgery and post op at home.. Bridging, even though off label, is a huge percentage of retail business. Also HIGH dose syringes (80,100,120mg); more revenue per patient over a Low dose syringe for surgery (30,40mg)
So anti-Xa orals to replace coumadin are a potential threat to that large bridging retail business because it would no longer be necessary.. I can't give you a specific number of what High Dose syringes are for retail but it is over 60%of total retail
With the oral anti-xa's continuing to show more signs of bleeding physicians may be weary to prescribe because you cannot monitor anit-xa easily unlike coumadin... And there are coumadin clinics that exist primarily to ensure patients are therapeutic between 2.0-3.0 INR. That business could suffer as well.. My point is uptake for anti-xa in those patients probably won't be as quick and good for SDZ and MNTA
Oral anti-xa for prophylaxsis of Surgery, however, not a large retail market for Lovenox so not as much of a threat.. Most surgeons prefer coumadin post op for total knee, hip or abdominal surgery.
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