Why is tinzaparin not widely used compared to Fragmin/Lovenox?

[fiorio]

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I am trying to find out the reason why tinzaparin is not as widely used as lovenox/fragmin.
I did not find any signigicant difference in therapeutic efficacy.
was it a cost/reimbursement issue?
any inputs appreciated!
thank you!

 

[njac]

for awhile it was cheaper so my hospital where I interned used it as preferred formulary agent.

I think the major reason is that it doesn't (or didn't when I was a student) come in prefilled syringes - we had to draw itup in the pharmacy from vials.