[The cost of pulmonary thromboembolism treatment]

Tuberk Toraks. 2020 Sep;68(3):293-304. doi: 10.5578/tt.70104.
[Article in Turkish]

Abstract

Introduction: Primary aim of this study is to determine the financial burden of Vitamin K Antagonists (VKA), low molecular weight heparins (LMWH) and new oral anticoagulants (NOAC) which are used in the treatment of the pulmonary thromboembolism (PTE). Secondary aim is to show long term complications of the treatment options.

Materials and methods: The patients who are diagnosed with PTE between May 2016 and March 2018 at Faculty of Medicine Karadeniz Technical University Hospital were observed prospectively. Hospitalization costs were calculated on patients who were treated only for PTE by hospitalized in the Chest Diseases Service in the acute period. Maintenance costs were calculated over all patients who regulary admitted to our outpatient clinic with the diagnosis of PTE. Data were presented as mean ± SD and median ± interquartilee range. A p-value of <0.05 was accepted to be significant.

Result: Fifty five (37.2%) of the patients were male, 93 (62.8%) were female and the median age was 68 (range 18-95). The median hospitalization time and cost of patients who are discharged with VKA (n: 22) compared with patients discharged with LMWH (n: 22) was found to be increased (1316.82 TL 7,5 days / 803.36 TL, 5 days p<0.001). Statistical analysis could not be performed with NOAC (n: 2). In the analysis of sixth month costs, LMWH cost was found to be higher than VKA cost (6.927.15 ± 2.687.67 TL/698.29 ± 483.51 TL p<0.001). However VKA treatment tended to be less expensive than treatment with NOACs (698.29 ± 483.51 TL/1.050.81 ± 300.28 TL p= 0.140).

Conclusions: In the acute period of PTE, VKA increases the length of hospitalization and hospital costs in patients treated at the hospital. In the maintenance period, VKA tends to have a lower cost compared to NOACs.

MeSH terms

  • Aged
  • Anticoagulants / administration & dosage
  • Anticoagulants / economics*
  • Female
  • Heparin, Low-Molecular-Weight / economics*
  • Hospital Costs
  • Hospitalization / economics
  • Humans
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / economics*
  • Turkey

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight