Direct Medical Costs Attributable to Cancer-Associated Venous Thromboembolism: A Population-based Longitudinal Study.
Am J Med. 2016 Mar 21;
Authors: Cohoon KP, Ransom JE, Leibson CL, Ashrani AA, Petterson TM, Long KH, Bailey KR, Heit JA
Abstract
PURPOSE: To estimate medical costs attributable to venous thromboembolism among patients with active cancer.
METHODS: In a population-based cohort study, we used Rochester Epidemiology Project (REP) resources to identify all Olmsted County, MN residents with incident venous thromboembolism and active cancer over the 18-year period, 1988-2005 (n=374). One Olmsted County resident with active cancer without venous thromboembolism was matched to each case on age, sex, cancer diagnosis date, and duration of prior medical history. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs from 1 year before index (venous thromboembolism event date or control matched date) to the earliest of death, emigration from Olmsted County, or December 31, 2011, with censoring on the shortest follow-up to ensure a similar follow-up duration for each case-control pair. We used generalized linear modeling to predict costs for cases and controls and bootstrapping methods to assess uncertainty and significance of mean adjusted cost differences. Outpatient drug costs were not included in our estimates.
RESULTS: Adjusted mean predicted costs were 1.9-fold higher for cases ($49,351) than for controls ($26,529) (P=<0.001) from index to up to 5 years post-index. Cost differences between cases and controls were greatest within the first 3 months (mean difference=$13,504) and remained significantly higher from 3 months to 5 years post-index (mean difference=$12,939).
CONCLUSIONS: Venous thromboembolism -attributable costs among patients with active cancer contribute a substantial economic burden and are highest from index to 3 months but may persist for up to 5 years.
PMID: 27012853 [PubMed - as supplied by publisher]