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Management of venous thromboembolism in cancer patients: the economic burden of hospitalizations

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Abstract

Purpose

Venous thromboembolism (VTE) is one of the most frequent events associated with cancer, requiring hospitalization and generating additional healthcare costs. To date, no studies analyzing the additional costs resulting from VTE associated with cancer in France have been published. The objective of this study was to provide an estimation of the additional cost induced by VTE with cancer by analyzing hospital stays reported in the 2013 PMSI French Hospital Database (“Programme de Médicalisation des Systèmes d’Information”, a national hospital administrative database) for four cancer types (breast, lung, hepatocellular carcinoma, and colon).

Methods

The analysis is divided into three parts: a descriptive evaluation of hospitalizations for VTE with cancer, an analysis by severity level of diagnosis-related groups (DRG), and an estimation of the hospital costs based on the National Reference Costs (ENC). The French public ATIH (“Agence Technique de l’Information sur l’Hospitalisation”, a national Agency for Data on Hospital Care) database was used. The critical approach of this study is based on analysis of the distribution of stays according to levels of severity of DRG.

Results

A total of 14,251 hospitalizations were analyzed combining VTE and cancer. Hospitalizations of the two highest levels of severity (levels 3 and 4) for VTE with cancer represented 81.7 % of all hospitalizations in this population. Increased costs were seen for all four cancer types evaluated, with cost coefficients ranging from 1.34 to 2.01. For example, the average cost of lung cancer in cancer patients with VTE in the PMSI database was 7296 € versus 4647 € in the ATIH database. Cost coefficients were calculated, ranging from 1.34 in colon cancer, 1.50 for breast cancer, 1.57 in lung cancer, and 2.01 for hepatocellular carcinoma.

Conclusion

As discussed in the article, the current costs are high. Better physician adherence to clinical practice guidelines could potentially reduce these costs by lowering the number of recurrent VTE in patients with cancer.

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Acknowledgments

This work was supported by Pfizer PFE France, and remuneration was provided to authors.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Internal Medicine Department, Louis Mourier Hospital, APHP, Paris 7 University, Colombes, France

    Isabelle Mahé

  2. Oncology Department, Mignot Hospital, 177, rue de Versailles, 78 157, Le Chesnay Cedex, France

    Didier Mayeur

  3. Oncology Support Care Department, Bergonié Institute, 229 Cours de l’Argonne CS 61283, 33076, Bordeaux Cedex, France

    Ivan Krakowski

  4. EA 7334 Université Paris Diderot, Sorbonne Paris Cité, Paris, France

    Isabelle Mahé

  5. Intergroupe AFSOS-UNICANCER, Paris, France

    Isabelle Mahé, Didier Mayeur & Ivan Krakowski

Authors
  1. Isabelle Mahé
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  2. Didier Mayeur
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  3. Ivan Krakowski
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Corresponding author

Correspondence to Isabelle Mahé.

Additional information

Data were collected and analyzed by Bourguignon S, health economist. From the “Stratégique Santé” company, Evry

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Mahé, I., Mayeur, D. & Krakowski, I. Management of venous thromboembolism in cancer patients: the economic burden of hospitalizations. Support Care Cancer 24, 4105–4112 (2016). https://doi.org/10.1007/s00520-016-3224-0

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  • DOI: https://doi.org/10.1007/s00520-016-3224-0

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