All-cause and disease-related health care costs associated with recurrent venous thromboembolism

Patrick Lefebvre; François Laliberté; Edith A. Nutescu; Mei Sheng Duh; Joyce LaMori; Brahim K. Bookhart; William H. Olson; Katherine Dea; Yvonnick Hossou; Jeff Schein; Scott Kaatz

doi:10.1160/TH13-05-0425

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2013; 110(06): 1288-1297
DOI: 10.1160/TH13-05-0425

Endothelium and Vascular Development

Schattauer GmbH

All-cause and disease-related health care costs associated with recurrent venous thromboembolism

Patrick Lefebvre

¹Groupe d’analyse, Ltée, Montréal, Quebec, Canada

,

François Laliberté

¹Groupe d’analyse, Ltée, Montréal, Quebec, Canada

,

Edith A. Nutescu

²Department of Pharmacy Practice & Center for Pharmacoepidemiology and Pharmacoeconomic Research, The University of Illinois at Chicago, Chicago, Illinois, USA

,

Mei Sheng Duh

³Analysis Group, Inc., Boston, Massachusetts, USA

,

Joyce LaMori

⁴Janssen Scientific Affairs LLC, Raritan, New Jersey, USA

,

Brahim K. Bookhart

⁴Janssen Scientific Affairs LLC, Raritan, New Jersey, USA

,

William H. Olson

⁴Janssen Scientific Affairs LLC, Raritan, New Jersey, USA

,

Katherine Dea

¹Groupe d’analyse, Ltée, Montréal, Quebec, Canada

,

Yvonnick Hossou

¹Groupe d’analyse, Ltée, Montréal, Quebec, Canada

,

Jeff Schein

⁴Janssen Scientific Affairs LLC, Raritan, New Jersey, USA

,

Scott Kaatz

⁵Hurley Medical Center, Flint, Michigan, USA

› Author Affiliations

Abstract

Summary

It was the objective of this study to quantify the risk of complications and the incremental health care costs associated with recurrent VTE events. Health care insurance claims from the Ingenix IMPACT database from 01/2004−09/2008 were analysed. Subjects aged ≥18 years on the date of first recurrent VTE diagnosis with ≥12 months of baseline observation prior to the index recurrent VTE were matched 1:1 with no-recurrent VTE patients based on propensity scores. The risk of developing post-thrombotic syndrome (PTS) and other disease-related diagnoses (thrombocytopenia, superficial venous thrombosis, venous ulcer, pulmonary hypertension, stasis dermatitis, and venous insufficiency) was compared between the recurrent and no-recurrent VTE groups for up to one year. All-cause and disease-related costs per patient per year (PPPY) were calculated. The recurrent VTE and no-recurrent VTE cohorts (8,001 subjects in each group) were matched with respect to age, gender, and comorbidities. The risk ratios (RRs) indicated that the risk of developing post-event complications was significantly higher for the recurrent VTE group compared to the no-recurrent VTE group (RR [95% CI]: PTS: 2.7 [2.4 − 2.9], p-value <0.01). Patients with recurrent VTE had significantly higher average PPPY all-cause costs compared to no-recurrent VTE patients ($86,744 versus $37,525, cost difference: $49,219 [€33,617]; 95% CI= 46,253−51,989). Corresponding disease-related health care costs PPPY were also significantly higher for the recurrent VTE group ($11,120 vs $1,262, cost difference: $9,858 [€6,733]; 95% CI= $9,081-$10,476). In conclusion, in this large matched-cohort study, recurrent VTE patients had significantly higher risk of complications and health care costs compared to no-recurrent VTE patients.

Note: Parts of this manuscript were presented at the American College of Clinical Pharmacy (ACCP) Annual Meeting 2012, October 21–24, Hollywood, Florida and at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 18th Annual International Meeting 2013, May 18–22, New Orleans, LA, USA.

Keywords

Recurrent venous thromboembolism - complications - risks - costs

Full Text

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