Abstract

The objective of this study was to assess deep vein thrombosis and pulmonary embolism (DVT/PE) recurrence rates and resource utilization among patients with an initial DVT or PE event across multiple payer perspectives. Retrospective analyses were performed using a software tool that analyzes health plan claims to evaluate treatment patterns and resource utilization for various cardiovascular conditions. Six databases were analyzed from three payer perspectives (Commercial, Medicare, and Medicaid). Patients were ≥18 years old with a primary diagnosis of DVT or PE associated with an inpatient and/or emergency room claim, had received an antithrombotic within 7 days before or 14 days after index, and had no diagnosis of atrial fibrillation during follow-up. Outcomes were assessed over a 1 year period following index. More PE patients were hospitalized for their index event than DVT patients (42–59 % DVT and 69–86 % PE) and had longer mean length of stay (2.35–2.95 days DVT and 3.26–3.76 days PE). Recurrent event rates among PE patients (12–32 %) were higher than those for DVT patients (6–16 %) across all payers. The highest rate of recurrence was observed among the Medicaid population [23 % overall (VTE); 16 % DVT; 32 % PE]. All-cause hospitalization in the year following their VTE episode occurred in 23–67 % DVT patients and 30–68 % PE patients. Medicaid had the highest proportion of patients with hospitalizations and ER visits. Recurrent VTE events and all-cause hospitalizations are relatively common, especially for patients who had a PE, and among those in the Medicaid payer population.

Highlights

  • All-cause hospitalization in the year following their Venous thromboembolism (VTE) episode occurred in 23–67 % deep vein thrombosis (DVT) patients and 30–68 % pulmonary embolism (PE)

  • Venous thromboembolism (VTE) is a medical condition referring to all thrombosis of the veins, consisting of both deep vein thrombosis (DVT) and pulmonary embolism (PE)

  • With more than half of deep vein thrombosis and pulmonary embolism (DVT/PE) cases being hospitalacquired [4], DVT/PE is associated with substantial healthcare resource utilization and costs

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Summary

Introduction

Venous thromboembolism (VTE) is a medical condition referring to all thrombosis (i.e., blood clots) of the veins, consisting of both deep vein thrombosis (DVT) and pulmonary embolism (PE). It is estimated that the annual incidence of DVT/PE is approximately 1–2 persons per 1,000 with the risk increasing significantly with age, presence of cancer, recent surgery, or prior DVT or PE events [1,2,3]. A retrospective analysis of administrative claims data from 2004–2008 estimated that patients with a DVT or PE event had approximately $16,000 higher mean annual all-cause medical costs compared to matched patients without DVT or PE ($33,000 vs $17,000), with hospitalizations representing the primary driver of the difference in cost ($17,174 vs $6,515) [5]

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