All-cause and disease-related health care costs associated with recurrent venous thromboembolism

It was the objective of this study to quantify the risk of complications and the incremental health care costs associated with recurrent VTE events. Health care insurance claims from the Ingenix IMPACT data' base from 01/2004-09/2008 were analysed. Subjects aged >= 18 years on the date of first recurrent VIE diagnosis with 12 months of baseline observation prior to the index recurrent VTE were matched 1:1 with no-recurrent VIE patients based on propensity scores. The risk of developing post-thrombotic syndrome (PTS) and other disease-related diagnoses (thrombocytopenia, superficial venous thrombosis, venous ulcer, pulmonary hypertension, stasis dermatitis, and venous insufficiency) was compared between the recurrent and no-recurrent VIE groups for up to one year. All-cause and disease-related costs per patient per year (PPPY) were calculated. The recurrent VIE and norecurrent VIE cohorts (8,001 subjects in each group) were matched with respect to age, gender, and comorbidities. The risk ratios (RRs) indicated that the risk of developing post-event complications was significantly higher for the recurrent VTE group compared to the no-recurrent VIE group (RR 195% CU: PTS: 2.7 114 2.9), p-value <0.01). Patients with recurrent VIE had significantly higher average PPPY all-cause costs compared to no-recurrent VIE patients ($86,744 versus $37,525, cost difference: $49,219 (33,6171; 95% Cl= 46,253-51,989). Corresponding disease-related health care costs PPPY were also significantly higher for the recurrent VIE group ($11,120 vs $1,262, cost difference: $9,858 [6,733); 95% Cl= $9,081-$10,476). In conclusion, in this large matched-cohort study, recurrent VIE patients had significantly higher risk of complications and health care costs compared to no-recurrent VIE patients.