Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States

Background: Estimates of the cost of long-term complications of a primary deep vein thrombosis (DVT), including the post-thrombotic syndrome (PTS) and recurrent venous thromboembolism (VTE), may be relevant for resource allocation decisions. Objective: The objective of this study was to provide US cost estimates of the long-term complications of a primary DVT, which occurs in approximately 5% to 20% (with adequate thromboprophylaxis) and 50% (in the absence of thromboprophylaxis) of total hip replacement surgeries (THRS). Methods: A literature-based model was used to project the excess long-term complication costs of DVT following THRS. The model simulated the natural history of DVT complications using published estimates of the incidence and prognosis of PTS and recurrent VTE. Each complication was assigned a cost obtained by multiplying the amount of resources used in its management by the unit price of these resources. Results: The annual per-patient cost of each complication was as follows: mild-to-moderate PTS, $839 in the first year and $341 in subsequent years; severe PTS, $3817 in the first year and $1677 in subsequent years; DVT, $3798; and pulmonary embolism, $6604. The average discounted lifetime cost of DVT complications was estimated to be $3069 (95% interval $2091-$4279). Conclusions: The long-term complications of a primary DVT represent a significant economic burden. Preventing a DVT could arguably lead to substantial savings in long-term DVT complications.