Health care resource use and costs of cancer-associated thrombosis in Sweden

Background

Cancer-associated thrombosis (CAT) is a severe disease that requires special medical attention as about 10% of cancer patients die from thrombotic events. Knowledge about resource utilization and costs of CAT is currently limited. The objective of this study was to identify CAT patients and examine mortality and utilization of health care and drug treatment for patients with CAT in Sweden, and estimate the associated costs.

Methods

This observational, retrospective study of patients with CAT was based on national registry data from the Swedish National Board of Health and Welfare (NBHW). Persons diagnosed with cancer and thrombosis in 2012 were identified via ICD10 codes for cancer and venous thromboembolism (VTE) in the national patient register. Inpatient and specialized outpatient care resource utilization, along with data on pharmaceutical treatment and mortality in the study population, were elicited from the NBHW registries. Data was analysed for a 2-year period after each patient's index date, i.e. after VTE diagnosis. Health care unit costs were collected from regional price lists and drug costs were extracted from the prescribed drugs registry.

Results

A total of 1504 cases were identified in 2012 (mean age 69 years; 45% male) out of which 16% had lung cancer, 13% colorectal cancer, 9% breast cancer and 5% prostate cancer while the majority (57%) had other cancer types. The most common VTE diagnoses were pulmonary embolism (56%) and deep vein thrombosis (37%), and 19% had more than one thrombosis related diagnosis. On average, patients were hospitalized fora total of 14 days and had 0.69 outpatient visits during the follow-up period. After 2 years, the mortality rate was 68%. Cancer was reported as the main cause of death in most cases (91%). Pulmonary embolism was reported as a contributing factor in 17% of the deaths. The total cost of CAT during the 2 years was €14 million (€9400 per patient), out of which 88% were related to inpatient care. Among the four major cancer diagnoses, the cost of CAT per patient was highest for colorectal cancer (€9800) and lowest for breast cancer (€4700).

Conclusions

CAT is associated with significant resource utilization and costs, out of which the largest portion is attributed to inpatient care.

Clinical trial identification

Legal entity responsible for the study

The Swedish Institute for Health Economics

Funding

Leo Pharma AB

Disclosure

M.V. Holm: Employeed at LEO Pharma AB, Sweden. All other authors have declared no conflicts of interest.