Cost associated with venous thromboembolism treatment in the community

Abstract

The aim was to compare the costs of treating venous thromboembolism in three possible clinical settings, either in-hospital, or out-of-hospital, by means of an anticoagulation clinic or by treatment at home. Initial treatment of venous thromboembolism involves the initiation of anticoagulation and the provision of concomitant antithrombotic therapy for 5-7 days, consisting of monitored, dose-adjusted, unfractionated heparin, given in-hospital, or low molecular weight heparin, given in a once-daily weight-adjusted dose, either in- or out-of-hospital. The cost model assumes that outcomes do not vary relative to the treatment administered. Costs were categorised under drug costs, administration costs and costs associated with care, both in- and out-of-hospital. Our study showed that savings can be made using Clexane* (enoxaparin) treatment without hospital admission. Total expected costs of enoxaparin provided in the community, incorporating nurse visits, were £241.70. The anticoagulation clinic costs were £433.70, compared with in-hospital unfractionated heparin at £1,183.13. Acute venous thromboembolism treatment in the community reduces costs, providing an incentive to manage patients out-of-hospital.