Direct Medical Costs Attributable to Cancer-Associated Venous Thromboembolism: A Population-Based Longitudinal Study. Am J Med 2016 Sep;129(9):1000.e15-25
Date
03/26/2016Pubmed ID
27012853Pubmed Central ID
PMC4996698DOI
10.1016/j.amjmed.2016.02.030Scopus ID
2-s2.0-84990044968 (requires institutional sign-in at Scopus site) 29 CitationsAbstract
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.
Author List
Cohoon KP, Ransom JE, Leibson CL, Ashrani AA, Petterson TM, Long KH, Bailey KR, Heit JAAuthor
Kevin Cohoon DO Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCase-Control Studies
Comorbidity
Cost of Illness
Female
Health Care Costs
Humans
Longitudinal Studies
Male
Minnesota
Neoplasms
Venous Thromboembolism
