Thromb Haemost 2016; 115(04): 800-808
DOI: 10.1160/TH15-08-0670
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH

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

Stefano Barco
1   Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, the Netherlands
2   Center for Thrombosis and Hemostasis, Johannes Gutenberg University, University Medical Center Mainz, Germany
,
Alex L. Woersching
3   Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
,
Alex C. Spyropoulos
4   Anticoagulation and Clinical Thrombosis Services, North Shore-LIJ Health System; Professor of Medicine – Hofstra North Shore-LIJ School of Medicine, Manhasset, New York, USA
,
Franco Piovella
5   Thromboembolic Disease Unit, Fondazione IRCCS Istituto Neurologico Nazionale Casimiro Mondino, Pavia, Italy
,
Charles E. Mahan
6   Presbyterian Healthcare Services, University of New Mexico, Albuquerque, New Mexico, USA
› Author Affiliations
Further Information

Publication History

Received: 24 August 2015

Accepted after major revision: 22 October 2015

Publication Date:
01 December 2017 (online)

Summary

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 (€) 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 €1.5–2.2 billion, €1.0–1.5 billion, €0.5–1.1 billion and €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 €1.8–3.3 billion, €1.2–2.4 billion, €0.6–1.8 billion and €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 €3.0–8.5 billion, €2.2–6.2 billion, €1.1–4.6 billion and €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 €1.5–13.2 billion, €1.0–9.7 billion, €0.5–7.3 billion and €0.2–6.1 billion, respectively. Our study demonstrates that VTE 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.

 
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