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Estimated Annual Costs of Prophylaxis and Treatment of Venous Thromboembolic Events Associated With Major Orthopedic Surgery in France

Pharmacie, Hôpital Saint Antoine, Paris

Antoine LaFuma, MD

Service d’Anesthésie, Hôpital Cochin, Paris, antoine.lafuma{at}cemka.fr

Xavier Colin, MSc

Service d’Anesthésie, Hôpital Cochin, Paris

Yves Ozier, MD, PhD

Cemka Eval, Bourg la Reine, France

Venous Thromboembolism (VTE) remains a major complication following orthopedic surgery despite heparin prophylaxis. Clinical consequences associated with this complication are deep vein thrombosis (DVT), pulmonary embolism, and long-term consequences of DVT, especially Postthrombotic syndrome (PTS). The purpose of the present study was to estimate the annual direct costs of VTE following major orthopedic surgery of the lower limb in France. This cost of illness study was performed by using available information from health system databases (1999) and literature and specific surveys (2002). Direct costs were calculated by using estimates of the number of patients with major orthopedic surgery in France during one year. Patients presenting with VTE were identified from the national disease-related group inpatient database. Additional resource consumption was identified by comparison with disease-related groups without the VTE complications. Ambulatory care costs after hospitalization, for recurrences and PTS, were estimated from specific surveys of general practitioners and venous disease specialists. Total annual costs of VTE associated with major orthopedic surgery for the French Sickness Fund were estimated to be approximately 60 million euros over 1 year with 28 million euros for inpatient care and 30 million euros for recurrences and PTS.

Key Words: Costs • Thromboembolic events • France • Prophylaxis • Major orthopedic surgery

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