Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: COSTECAT Study
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CAT | Cancer Associated Venous Thromboembolism |
DVT | Deep Vein Thrombosis |
ICU | Intensive Care Unit |
IQR | Interquartile Range |
LC | Lung Cancer |
LMWH | Low Molecular Weight Heparins |
PE | Pulmonary Embolism |
SD | Standard Deviation [IQR]) |
VTE | Venous Thromboembolism |
References
- Golinelli, D.; Toscano, F.; Bucci, A.; Lenzi, J.; Fantini, M.P.; Nante, N.; Messina, G. Health Expenditure and All-Cause Mortality in the ‘Galaxy’ of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis. Appl. Health Econ. Health Policy 2017, 15, 773–783. [Google Scholar] [CrossRef]
- Grau, E.; Real, E.; Medrano, J.; Pastor, E.; Selfa, S. Recurrent venous thromboembolism in a Spanish population: Incidence, risk factors, and management in a hospital setting. Thromb. Res. 1999, 96, 335–341. [Google Scholar] [CrossRef]
- Merino, R.G.; Santiago, J.M.; San Román, C.M. Epidemiología hospitalaria de la enfermedad tromboembólica venosa en España. Med. Clín. 2008, 131, 2–9. [Google Scholar] [CrossRef]
- Lyman, G.H.; Culakova, E.; Poniewierski, M.S.; Kuderer, N.M. Morbidity, mortality and costs associated with venous thromboembolism in hospitalized patients with cancer. Thromb Res. 2018, 164 (Suppl. 1), S112–S118. [Google Scholar] [CrossRef] [PubMed]
- Abdol Razak, N.B.; Jones, G.; Bhandari, M.; Berndt, M.C.; Metharom, P. Cancer-Associated Thrombosis: An Overview of Mechanisms, Risk Factors, and Treatment. Cancers 2018, 10, 380. [Google Scholar] [CrossRef] [PubMed]
- Sheth, R.A.; Niekamp, A.; Quencer, K.B.; Shamoun, F.; Knuttinen, M.-G.; Naidu, S.; Oklu, R. Thrombosis in cancer patients: Etiology, incidence, and management. Cardiovasc. Diagn. Ther. 2017, 7, S178–S185. [Google Scholar] [CrossRef] [PubMed]
- López-Núñez, J.J.; Trujillo-Santos, J.; Jiménez-García, R. Management of venous thromboembolism in patients with cancer. J. Thromb. Haemost. 2018, 16, 2391–2396. [Google Scholar] [CrossRef]
- Pachón, V.; Trujillo-Santos, J.; Domènech, P.; Gallardo, E.; Font, C.; González-Porras, J.R.; Pérez-Segura, P.; Maestre, A.; Mateo, J.; Muñoz, A.; et al. Cancer-Associated Thrombosis: Beyond Clinical Practice Guidelines-A Multidisciplinary (SEMI-SEOM-SETH) Expert Consensus. TH Open 2018, 2, e373–e386. [Google Scholar] [CrossRef]
- Posch, F.; Königsbrügge, O.; Zielinski, C.C.; Pabinger, I.; Ay, C. Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants. Thromb. Res. 2015, 136, 582–589. [Google Scholar] [CrossRef]
- Kourlaba, G.; Relakis, J.; Kontodimas, S.; Holm, M.; Maniadakis, N. The Humanistic and Economic Burden of Venous Thromboembolism in Cancer Patients: A Systematic Review. Value Heal. 2013, 16, 13–31. [Google Scholar] [CrossRef][Green Version]
- Marin-Barrera, L.; Muñoz, A.; Rios-Herranz, E.; García-Escobar, I.; Beato, C.; Font, C.; Oncala-Sibajas, E.; Revuelta-Rodriguez, A.; Manrique, M.C.A.; Rivas-Jimenez, V.; et al. A Case-Control Analysis of the Impact of Venous Thromboembolic Disease on Quality of Life of Patients with Cancer: Quality of Life in Cancer (Qca) Study. Cancers 2019, 12, 75. [Google Scholar] [CrossRef]
- Macbeth, F.; Noble, S.; Evans, J.; Ahmed, S.; Cohen, D.; Hood, K.; Knoyle, D.; Linnane, S.; Longo, M.; Moore, B.; et al. Randomized Phase III Trial of Standard Therapy Plus Low Molecular Weight Heparin in Patients With Lung Cancer: FRAGMATIC Trial. J. Clin. Oncol. 2016, 34, 488–494. [Google Scholar] [CrossRef] [PubMed]
- Global Cancer Observatory. Available online: https://gco.iarc.fr/ (accessed on 30 November 2019).
- eSalud. Oblikue Consulting. Available online: http://www.oblikue.com/bddcostes/ (accessed on 30 November 2018).
- Consejo General de Colegios Oficiales de Farmacéuticos. BOT Plus Web. Available online: https://botplusweb.portalfarma.com/ (accessed on 30 November 2018).
- Dentali, F.; Ageno, W.; Becattini, C.; Galli, L.; Gianni, M.; Riva, N.; Imberti, D.; Squizzato, A.; Venco, A.; Agnelli, G. Prevalence and clinical history of incidental, asymptomatic pulmonary embolism: A meta-analysis. Thromb Res. 2010, 125, 518–522. [Google Scholar] [CrossRef]
- Carmona-Bayonas, A.; on behalf of the Asociación de Investigación de la Enfermedad Tromboembólica de la Región de Murcia (the Region of Murcia’s Association of Thromboembolic Disease Research); Jiménez-Fonseca, P.; Font, C.; Fenoy, F.; Otero, R.; Beato, C.; Plasencia, J.M.; Biosca, M.; Sánchez, M.; et al. Predicting serious complications in patients with cancer and pulmonary embolism using decision tree modelling: The EPIPHANY Index. Br. J. Cancer 2017, 116, 994–1001. [Google Scholar] [CrossRef] [PubMed]
- Khorana, A.A.; Dalal, M.R.; Lin, J.; Connolly, G.C. Health care costs associated with venous thromboembolism in selected high-risk ambulatory patients with solid tumors undergoing chemotherapy in the United States. Clin. Outcomes Res. 2013, 5, 101–108. [Google Scholar] [CrossRef] [PubMed]
- Li, Y.; Shang, Y.; Wang, W.; Ning, S.; Chen, H. Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review. J. Cancer 2018, 9, 3046–3057. [Google Scholar] [CrossRef]
- Font, C.; Carmona-Bayonas, A.; Beato, C.; Reig, Ò.; Sáez, A.; Jiménez-Fonseca, P.; Plasencia, J.M.; Calvo-Temprano, D.; Sanchez, M.; Benegas, M.; et al. Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: The EPIPHANY study. Eur. Respir. J. 2016, 49, 1600282. [Google Scholar] [CrossRef] [PubMed]
- Spyropoulos, A.C.; Lin, J. Direct Medical Costs of Venous Thromboembolism and Subsequent Hospital Readmission Rates: An Administrative Claims Analysis from 30 Managed Care Organizations. J. Manag. Care Pharm. 2007, 13, 475–486. [Google Scholar] [CrossRef]
- Khorana, A.A.; McCrae, K.R.; Milentijevic, D.; Laliberté, F.; Lejeune, D.; Crivera, C.; Lefebvre, P. Healthcare resource utilization and costs associated with venous thromboembolism recurrence in patients with cancer. J. Med. Econ. 2020, 23, 323–329. [Google Scholar] [CrossRef]
- Norrlid, M.V.; Holm, J.; Norlin, P.; Svensson, G.; Tennvall, R. Health care resource use and costs of cancer-associated thrombosis in Sweden. In Proceedings of the Poster presentado en el congreso anual de la European Society for Medical Oncology (ESMO), Copenhagen, Denmark, 7–11 October 2016. [Google Scholar]
- Streiff, M.; Milentijevic, D.; McCrae, K.R.; Laliberté, F.; Lejeune, D.; Lefebvre, P.; Schein, J.; Khorana, A.A. Healthcare resource utilization and costs associated with venous thromboembolism in cancer patients treated with anticoagulants. J. Med. Econ. 2019, 22, 1134–1140. [Google Scholar] [CrossRef]
- Louzada, M.L.; Majeed, H.; Dao, V.; Wells, P.S. Risk of recurrent venous thromboembolism according to malignancy characteristics in patients with cancer-associated thrombosis: A systematic review of observational and intervention studies. Blood Coagul. Fibrinolysis 2011, 22, 86–91. [Google Scholar] [CrossRef] [PubMed]
- Chee, C.E.; Ashrani, A.A.; Marks, R.S.; Petterson, T.M.; Bailey, K.R.; Melton, L.J.; Heit, J.A. Predictors of venous thromboembolism recurrence and bleeding among active cancer patients: A population-based cohort study. Blood 2014, 123, 3972–3978. [Google Scholar] [CrossRef] [PubMed]
Features | N = 47 |
---|---|
Gender (male), number patients (%) | 31 (66.0) |
Age, mean ± SD | 65.4 ± 9.5 |
Weight (Kg) mean ± SD | 72.0 ± 15.5 |
Height (cm) mean ± SD | 167.7 ± 8.5 |
Smoking, number patients (%) | 20 (42.6) |
Patients who do physical activity, number patients (%) | 23 (48.9) |
Patients with central venous catheter (%) | 8 (17.0) |
TNM staging system, number patients (%) | |
Stage IIB | 4 (8.5) |
Stage IIIA | 2 (4.3) |
Stage IIIB | 5 (10.6) |
Stage IV | 35 (74.5) |
Unknown | 1 (2.1) |
ECOG performance status, number patients (%) | |
ECOG 0 | 6 (12.8) |
ECOG 1 | 27 (57.4) |
ECOG 2 | 6 (12.8) |
ECOG 3 | 5 (10.6) |
ECOG 4 | 2 (4.3) |
Unknown | 1 (2.1) |
Cancer stage, number patients (%) | |
Locally | 4 (8.5) |
Locally advanced | 6 (12.8) |
Metastatic | 37 (78.7) |
Chronic comorbidities, number patients (%) * | |
Stroke | 4 (8.5) |
Prior VTE | 5 (10.6) |
Obesity | 3 (6.4) |
Chronic venous insufficiency | 3 (6.4) |
Congestive heart failure (III or IV stage) | 2 (4.3) |
Myocardial infarction | 1 (2.1) |
Decompensated COPD | 7 (14.9) |
Infection (acute/severe) | 10 (21.3)/6 (12.8) |
Bleeding history | 6 (12.8) |
Renal insufficiency | 4 (8.51) |
Thrombocytopenia | 6 (12.8) |
Cancer treatment in VTE episode, number patients (%) | |
No treatment | 10 (21.3) |
Chemotherapy | 23 (48.9) |
Targeted therapy | 6 (12.8) |
Immunotherapy | 4 (8.5) |
Palliative care | 3 (6.4) |
Radiotherapy | 1 (2.10) |
Other | 4 (8.5) |
LMWH treatment, number patients (%) | |
Bemiparin | 6 (12.8) |
Enoxaparin | 25 (53.2) |
Tinzaparin | 15 (31.9) |
Unknown | 1 (2.1) |
Direct Healthcare Resource | N = 47 (%) | Average Cost Per Patient (€) (SD) | % Total Cost |
---|---|---|---|
Hospital stay * | 23 (48.9) | 7207.3 (13,996.9) | 65.8 |
ICU stay ** | 2 (4.2) | 189.9 (1000.1) | 1.8 |
Emergency room visits | 26 (55.3) | 126.4 (160.1) | 1.2 |
Hospital specialist visits | 27 (57.4) | 329.4 (654.3) | 3.0 |
Laboratory tests | 38 (80.9) | 399.6 (567.0) | 3.7 |
Imagine tests | 38 (80.9) | 601.3 (896.8) | 5.5 |
LMWH treatment | 47 *** (100) | 2033.8 (630.5) | 18.6 |
bemiparin | 6 (12.8) | 2613.4 (1052.6) | |
enoxaparin | 25 (53.2) | 2173.9 (527.0) | |
tinzaparin | 15 (31.9) | 1568.7 (153.3) | |
Healthcare transportation | 12 (25.5) | 15.5 (30.6) | 0.2 |
Home specialist visits | 5 (10.6) | 42.8 (200.2) | 0.4 |
Out-patient rehabilitation | 0 (0) | 0 (0) | 0 |
Total Cost | 47 (100) | 10,969.6 (14,554.2) | 100 |
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Rubio-Salvador, A.R.; Escudero-Vilaplana, V.; Marcos Rodríguez, J.A.; Mangues-Bafalluy, I.; Bernardez, B.; García Collado, C.; Collado-Borrell, R.; Alvarado Fernández, M.D.; Chacón López-Muñiz, J.I.; Yébenes Cortés, M.; et al. Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: COSTECAT Study. Int. J. Environ. Res. Public Health 2021, 18, 394. https://doi.org/10.3390/ijerph18020394
Rubio-Salvador AR, Escudero-Vilaplana V, Marcos Rodríguez JA, Mangues-Bafalluy I, Bernardez B, García Collado C, Collado-Borrell R, Alvarado Fernández MD, Chacón López-Muñiz JI, Yébenes Cortés M, et al. Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: COSTECAT Study. International Journal of Environmental Research and Public Health. 2021; 18(2):394. https://doi.org/10.3390/ijerph18020394
Chicago/Turabian StyleRubio-Salvador, Ana Rosa, Vicente Escudero-Vilaplana, José Antonio Marcos Rodríguez, Irene Mangues-Bafalluy, Beatriz Bernardez, Carlos García Collado, Roberto Collado-Borrell, María Dolores Alvarado Fernández, José Ignacio Chacón López-Muñiz, María Yébenes Cortés, and et al. 2021. "Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: COSTECAT Study" International Journal of Environmental Research and Public Health 18, no. 2: 394. https://doi.org/10.3390/ijerph18020394
APA StyleRubio-Salvador, A. R., Escudero-Vilaplana, V., Marcos Rodríguez, J. A., Mangues-Bafalluy, I., Bernardez, B., García Collado, C., Collado-Borrell, R., Alvarado Fernández, M. D., Chacón López-Muñiz, J. I., Yébenes Cortés, M., Gómez Barrera, M., & Calleja-Hernández, M. Á. (2021). Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: COSTECAT Study. International Journal of Environmental Research and Public Health, 18(2), 394. https://doi.org/10.3390/ijerph18020394