The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs.
The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs.
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DOI：
10.1016/j.thromres.2015.11.033
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发表时间：
2016-01
影响因子：
7.5
通讯作者：
Raskob GE
中科院分区：
文献类型：
--
作者：
Grosse SD;Nelson RE;Nyarko KA;Richardson LC;Raskob GE
静脉血栓栓塞症（VTE），包括深静脉血栓形成和肺栓塞，是可预防的死亡和发病的重要原因。在这项研究中，我们总结了估计每个病人和总的医疗成本或支出归因于事件静脉血栓栓塞在美国。每例患者的增量成本估计值可以计算为在控制基础健康状况差异后，发生和未发生事件的患者之间的成本差异。我们确定了急性VTE和VTE相关并发症（包括复发性VTE、血栓形成后综合征、慢性血栓栓塞性肺动脉高压和抗凝相关不良药物事件）的每例患者增量成本估计值。根据所确定的研究，在控制风险因素的情况下，急性静脉血栓栓塞的治疗平均与第一年幸存者增加的12，000至15，000美元（2014年美元）的直接医疗费用相关。据保守估计，后续并发症将使累积成本增加到每个事件病例18，000 - 23，000美元。保守估计，每年新发VTE事件使美国医疗保健系统花费70 - 100亿美元，用于375，000 - 425，000例新诊断、经医学治疗的新发VTE病例。未来的研究应该跟踪VTE患者队列的长期成本，控制已被证明与VTE相关的共病状况，并估计无法生存的VTE患者的增量医疗成本。与治疗VTE相关的成本可用于评估预防工作的潜在经济效益和成本节约，尽管不同患者群体的成本会有所不同。
Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is an important cause of preventable mortality and morbidity. In this study, we summarize estimates of per-patient and aggregate medical costs or expenditures attributable to incident VTE in the United States. Per-patient estimates of incremental costs can be calculated as the difference in costs between patients with and without an event after controlling for differences in underlying health status. We identified estimates of the incremental per-patient costs of acute VTEs and VTE-related complications, including recurrent VTE, post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension, and anticoagulation-related adverse drug events. Based on the studies identified, treatment of an acute VTE on average appears to be associated with incremental direct medical costs of $12,000 to $15,000 (2014 US dollars) among first-year survivors, controlling for risk factors. Subsequent complications are conservatively estimated to increase cumulative costs to $18,000–23,000 per incident case. Annual incident VTE events conservatively cost the US healthcare system $7–10 billion each year for 375,000 to 425,000 newly diagnosed, medically treated incident VTE cases. Future studies should track long-term costs for cohorts of people with incident VTE, control for comorbid conditions that have been shown to be associated with VTE, and estimate incremental medical costs for people with VTE who do not survive. The costs associated with treating VTE can be used to assess the potential economic benefit and cost-savings from prevention efforts, although costs will vary among different patient groups.