European Union-28: An annualised cost-of-illness model for venous thromboembolism

被引:104
作者
Barco, Stefano [1 ,2 ]
Woersching, Alex L. [3 ]
Spyropoulos, Alex C. [4 ,5 ,6 ]
Piovella, Franco [7 ]
Mahan, Charles E. [8 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1012 WX Amsterdam, Netherlands
[2] Johannes Gutenberg Univ Mainz, Univ Med Ctr Mainz, Ctr Thrombosis & Hemostasis, Mainz, Germany
[3] Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA
[4] North Shore LIJ Hlth Syst, Anticoagulat Serv, Manhasset, NY USA
[5] North Shore LIJ Hlth Syst, Clin Thrombosis Serv, Manhasset, NY USA
[6] Hofstra North Shore LIJ Sch Med, Med, Manhasset, NY USA
[7] Fdn IRCCS Ist Neurol Nazl Casimiro Mondino, Thromboembol Dis Unit, Pavia, Italy
[8] Univ New Mexico, Presbyterian Healthcare Serv, Albuquerque, NM 87131 USA
关键词
Venous thromboembolism; annual costs; European Union; preventable costs; thromboprophylaxis; DEEP-VEIN THROMBOSIS; HEPARIN-INDUCED THROMBOCYTOPENIA; MOLECULAR-WEIGHT HEPARIN; KNEE REPLACEMENT; UNITED-STATES; DABIGATRAN ETEXILATE; TOTAL HIP; COMPARING RIVAROXABAN; ECONOMIC-EVALUATION; PULMONARY-EMBOLISM;
D O I
10.1160/TH15-08-0670
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Annual costs for venous thromboembolism (VTE) have been defined within the United States (US) demonstrating a large opportunity for cost savings. Costs for the European Union-28 (EU-28) have never been defined. A literature search was conducted to evaluate EU-28 cost sources. Median costs were defined for each cost input and costs were inflated to 2014 Euros ((sic)) in the study country and adjusted for Purchasing Power Parity between EU countries. Adjusted costs were used to populate previously published cost-models based on adult incidence-based events. In the base model, annual expenditures for total, hospital-associated, preventable, and indirect costs were (sic)1.5-2.2 billion, (sic)1.0-1.5 billion, (sic)0.5-1.1 billion and (sic)0.2-0.3 billion, respectively (indirect costs: 12% of expenditures). In the long-term attack rate model, total, hospital-associated, preventable, and indirect costs were (sic)1.8-3.3 billion, (sic)1.2-2.4 billion, (sic)0.6-1.8 billion and (sic)0.2-0.7 billion (indirect costs: 13 % of expenditures). In the multiway sensitivity analysis, annual expenditures for total, hospital associated, preventable, and indirect costs were (sic)3.0-8.5 billion, (sic)2.2-6.2 billion, (sic)1.1-4.6 billion and (sic)0.5-1.4 billion (indirect costs: 22 % of expenditures). When the value of a premature life-lost increased slightly, aggregate costs rose considerably since these, costs are higher than the direct medical costs. When evaluating the models aggregately for costs, the results suggests total, hospital-associated, preventable, and indirect costs ranging from (sic)1.5-13.2 billion, (sic)1.0-9.7 billion, (sic)0.5-7.3 billion and (sic)0.2-6.1 billion, respectively. Our study demonstrates that VIE costs have a large financial impact upon the EU-28's healthcare systems and that significant savings could be realised if better preventive measures are applied.
引用
收藏
页码:800 / 808
页数:9
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