Direct Medical Costs Attributable to Cancer-Associated Venous Thromboembolism: A Population-Based Longitudinal Study - 21/08/16
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Abstract |
Purpose |
The purpose of this study is 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, Minn. 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 prior to 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 < .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.
Le texte complet de cet article est disponible en PDF.Keywords : Active cancer, Cost analysis, Cost of illness, Deep vein thrombosis, Medical care utilization, Pulmonary embolism, Venous thromboembolism
Plan
Funding: Research reported in this publication was supported in part by grants from the National Heart, Lung, and Blood Institute under Award Numbers R01HL66216 and K12HL83141 (a training grant in Vascular Medicine [KPC]) to JAH, and was made possible by the Rochester Epidemiology Project (Award Number R01AG034676 of the National Institute on Aging, National Institutes of Health). Research support also was provided by Mayo Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. |
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Conflict of Interest: None. |
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Authorship: All authors had a role in writing the manuscript and had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. |
Vol 129 - N° 9
P. 1000.e15-1000.e25 - septembre 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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