Thromboembolism after Chemotherapy Raises Healthcare Costs about 30%

Caroline Helwick

December 2011, Vol 2, No 7 - ESMO 2011 Conference

Stockholm, Sweden—The development of venous thromboembolism (VTE) in patients with cancer has a significant impact in terms of morbidity and mortality and healthcare costs, according to a “real-world analysis” reported at the 2011 European Multi – disciplinary Cancer Congress.

Gary H. Lyman, MD, MPH, an on – cologist and Director of Comparative Effectiveness and Outcomes Research, Duke University School of Medicine, Durham, NC, was principal investigator. “VTE development was associated with a significant economic burden in terms of healthcare expenditure,” Dr Lyman said.

Dr Lyman and colleagues assessed the economic impact of VTE events using the US-based InVision Data Mart Multiplan/Integrated Health Care Information Solutions database. They retrospectively identified 30,552 patients with cancer who initiated chemotherapy in the 4-year period ending in 2008. Healthcare costs such as inpatient, pharmacy, emergency department, and outpatient expenses were assessed at 1-year pre- and post – index treatment (first day of chemo – therapy after cancer diagnosis).

The incidence of VTE 3.5 months after the initiation of chemotherapy ranged from 4.8% to 11.9%, depending on the tumor site. The highest risk was observed in patients with pancreatic, stomach, and lung cancer. The incidence continued to increase over time postindex treatment, peaking at 9.9% to 21.5% at 12 months, Dr Lyman reported.

Healthcare Costs of Patients with and without VTE
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High Healthcare Costs
Patients who developed VTE within 3.5 months postindex treatment had healthcare costs at baseline that were comparable with persons not developing VTE. During first-year postindex treatment, the costs for patients with VTE were significantly higher than those for patients without VTE; the increase was driven primarily by higher inpatient and outpatient costs (Figure).

The overall healthcare costs 1 year before receiving chemotherapy were $37,542 for patients developing VTE and $35,342 for those without VTE. By 1-year postindex treatment, costs had risen to $110,362 and $77,984, respectively, Dr Lyman reported.

Costs were higher for patients with VTE in each category of expenditure: inpatient, outpatient, emergency de – partment, and pharmacy.

“Similar results were seen for patients who developed VTE within 12 months postindex,” he said.

“The decision for the use of thromboprophylaxis in cancer patients undergoing chemotherapy should be based on the balance between the potential benefits and harms, including any bleeding risk associated with a therapy,” Dr Lyman pointed out, emphasizing the need to assess costeffectiveness and cost-utility of prevention in this setting.