The Cost of Hospitalization for Thromboembolic Events in Patients with Colon or Lung Cancer

Background: Venous Thromboembolic Event (VTE) is a common complication for cancer patients, leading to hospitalizations that increase the burden of cancer management. We evaluated the incidence and costs of VTE-related hospitalizations for patients with colon cancer (CC) or lung cancer (LC).

Methods: The French national hospital database (PMSI) was analyzed in order to identify patients whose colon cancer or lung cancer was diagnosed in 2010 and who were hospitalized for a VTE at least once during the following two years. The numbers of stays induced by a VTE, and the corresponding number of patients hospitalized, were determined using the disease-specific ICD-10 codes. Associated hospital costs were estimated from the perspective of the third-party payer, using the French official tariffs, on the 1,111 and 1,641 hospitalizations with VTE classified as primary or related diagnosis only (PD / RD) for colon and lung cancer patients, respectively.

Results: We identified 47,954 new patients with colon cancer and 39,454 new patients with lung cancer; in each group, 2,866 (6.0%) and 3,775 (9.6%), respectively, were hospitalized for a VTE or had a VTE during their hospital stay. During the 2 years of follow-up of these 6,641 patients, 1,707 (25.7%) were hospitalized for a VTE recurrence. In total, 4,104 stays for CC patients and 5,962 stays for LC patients were analyzed, including stays for recurrence.

In colon cancer patients, the mean cost per stay for a VTE classified as PD / RD amounted to 3,612 Euros and 3,457 Euros for first event and recurrence, respectively, and in lung cancer patients, to 3,674 Euros and 3,222 Euros for first event and recurrence, respectively. During the time of the study, mean hospitalization cost per patient who had at least one stay for recurrence was 5,441 Euros and 5,676 Euros in colon and lung cancer, respectively. Over a 2-year period, the total cost of hospital stays induced by VTEs classified as PD / RD reached 3.99 million Euros and 5.90 million Euros for colon and lung cancer, respectively, including a total amount of 1.49 million Euros for VTE recurrence.

Conclusion: In colon and lung cancer patients, VTE-related hospitalizations remain frequent and induce an elevated cost. This economic burden may be reduced by decreasing the occurrence of thromboembolic complications, using adequate prophylaxis and efficient management in this at-risk population.