Direct Medical Cost of Managing Deep Vein Thrombosis According to the Occurrence of Complications
Judith A. O'Brien
Jaime J. Caro
Background: Management of deep vein thrombosis (DVT) has evolved from hospitalisation for intravenous heparin therapy to treatment options that include acute management as an outpatient. While efficacy and safety remain the principal basis for choosing a therapy, the economic consequences of that choice should be considered as well. Objective: To estimate the average cost of various DVT management options from the perspective of US health payers. Design: Inpatient and outpatient management strategies were examined. Inpatient cases were identified by International Classification of Diseases, 9th Edition, Clinical Modification codes and were classified into subgroups according to complication status. A cost estimate was developed by applying unit costs to the corresponding course of treatment. Cost estimates included initial acute care and that occurring in the following 6 months. Resource use profiles and unit costs were derived from several statewide inpatient, emergency room and ambulatory care databases supplemented by national fee schedules, published reports and peer-reviewed literature. All costs are reported in 1999 US dollars. Results: The mean 6-month treatment costs for inpatient management ranged from $US3906 to $US17 168, depending on complication status. For outpatient management, the cost ranged from $US2394 to $US3369, depending on frequency of low molecular weight heparin (LMWH) injection and need for professional assistance. Conclusions: The management strategy selected for DVT has an important economic impact. Self-administered LMWH in a homecare setting results in the lowest cost. However, as some patients either cannot, or will not, be treated this way, it is important for decision makers to consider the costs of other strategies.
Antithrombotics, Cost analysis, Deep vein thrombosis, Pharmacoeconomics
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