Abstract 229: Economic Burden of Deep Vein Thrombosis and Pulmonary Embolism for Employees and Employers

Author(s):  
Robert L Page ◽  
Vahram Ghushchyan ◽  
Brian Gifford ◽  
Richard R Allen ◽  
Monika Raut ◽  
...  

Introduction: Though, deep vein thrombosis (DVT) and pulmonary embolism (PE) impose a major burden on US healthcare system, limited data exists on the economic impact of DVT and PE on younger working population. DVT, which occurs in approximately 1 in every 1,000 adults every year, is estimated to cost between $5-8 billion annually or on average $20,000 per treated patient per year. PE occurs in 0.6 million patients annually and results in 50,000 to 200,000 deaths every year. This study examined the total burden of illness, including the direct and indirect healthcare costs to employers and employees with DVT and PE. Methods: Retrospective analyses from 2007-2010 were performed using two datasets: (1) Integrated Benefits Institute’s Health and Productivity Benchmarking Database was used for short-term disability (STD) and long term disability (LTD) claims, and (2) IMS LifeLink data was used for medical and pharmacy claims. Indirect costs analyses included costs of lost work days from STD and LTD claims and wage replacement costs. Direct costs included annual pharmacy and medical claims for newly diagnosed DVT and/or PE individuals. Total healthcare cost estimates between the two datasets were linked by derived age and gender analytic weights. Results: 5,445 (female=54%) and 6,199 (female=50%) disability claims were filed for DVT and PE, respectively. Employees with DVT lost on average 57 (SEM 4.6) STD and 440 (SEM 30.5) LTD days per disability incident. For employers, estimated lost productivity costs per DVT claim were STD=$7,414±625 and LTD= $58,181±4,332. Total annual DVT healthcare costs per employee including out of pocket costs were $2,449 + 106 with $2,160±102 for annual medical and $290 ±20 for total pharmacy costs. Employees with PE lost on average 56 (SEM 3.0) STD and 364 (SEM 26.1) LTD days per disability incident. For employers, the estimated lost productivity costs per PE claim for STD and LTD were $7,605±402 and $48,751±3,615, respectively. Total annual PE healthcare costs per employee including out of pocket costs were $5,040 + 460 with $4,851±457 for annual medical and $190 ±22 for total pharmacy costs. Hospitalizations accounted for 84% of total annual PE health costs. Conclusion: DVT and PE constitute a heavy economic and lost productivity burden for both employers and their employees. Direct and disability costs to employees are substantial. Productivity losses for employers are also significantly high. Appropriate management of DVT and PE may help improve lost days from work, reduce healthcare resource utilization, improve workforce productivity, and reduce total economic burden.

2008 ◽  
Vol 134 (4) ◽  
pp. A-878
Author(s):  
Debraj Mukherjee ◽  
Susan L. Gearhart ◽  
Anne O. Lidor ◽  
David C. Chang

2006 ◽  
Vol 63 (20_Supplement_6) ◽  
pp. S5-S15 ◽  
Author(s):  
David A. MacDougall ◽  
Anthony L. Feliu ◽  
Stephen J. Boccuzzi ◽  
Jay Lin

The Lancet ◽  
2006 ◽  
Vol 367 (9516) ◽  
pp. 1075-1079 ◽  
Author(s):  
Liam Smeeth ◽  
Claire Cook ◽  
Sara Thomas ◽  
Andrew J Hall ◽  
Richard Hubbard ◽  
...  

2020 ◽  
Vol 30 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Julia Rose Salinaro ◽  
Kourtnie McQuillen ◽  
Megan Stemple ◽  
Robert Boccaccio ◽  
Jessie Ehrisman ◽  
...  

ObjectivesNeoadjuvant chemotherapy may be considered for women with epithelial ovarian cancer who have poor performance status or a disease burden not amenable to primary cytoreductive surgery. Overlap exists between indications for neoadjuvant chemotherapy and known risk factors for venous thromboembolism, including impaired mobility, increasing age, and advanced malignancy. The objective of this study was to determine the rate of venous thromboembolism among women receiving neoadjuvant chemotherapy for epithelial ovarian cancer.MethodsA multi-institutional, observational study of patients receiving neoadjuvant chemotherapy for primary epithelial ovarian, fallopian tube, or peritoneal cancer was conducted. Primary outcome was rate of venous thromboembolism during neoadjuvant chemotherapy. Secondary outcomes included rates of venous thromboembolism at other stages of treatment (diagnosis, following interval debulking surgery, during adjuvant chemotherapy, or during treatment for recurrence) and associations between occurrence of venous thromboembolism during neoadjuvant chemotherapy, subject characteristics, and interval debulking outcomes. Venous thromboembolism was defined as deep vein thrombosis in the upper or lower extremities or in association with peripherally inserted central catheters or ports, pulmonary embolism, or concurrent deep vein thrombosis and pulmonary embolism. Both symptomatic and asymptomatic venous thromboembolism were reported.ResultsA total of 230 patients receiving neoadjuvant chemotherapy were included; 63 (27%) patients overall experienced a venous thromboembolism. The primary outcome of venous thromboembolism during neoadjuvant chemotherapy occurred in 16 (7.7%) patients. Of the remaining venous thromboembolism events, 22 were at diagnosis (9.6%), six post-operatively (3%), five during adjuvant chemotherapy (3%), and 14 during treatment for recurrence (12%). Patients experiencing a venous thromboembolism during neoadjuvant chemotherapy had a longer mean time to interval debulking and were less likely to undergo optimal cytoreduction (50% vs 80.2%, p=0.02).ConclusionsPatients with advanced ovarian cancer are at high risk for venous thromboembolism while receiving neoadjuvant chemotherapy. Consideration of thromboprophylaxis may be warranted.


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