Direct Medical Cost of Managing Deep Vein Thrombosis According to the Occurrence of Complications Judith A. O’Brien 1 and Jaime J. Caro 1,2 1 Caro Research Institute, Concord, Massachusetts, USA 2 Division of General Internal Medicine, Royal Victoria Hospital, McGill University, Montreal, Canada Abstract Background: Management of deep vein thrombosis (DVT) has evolved from hospitalisation for intravenous heparin therapy to treatment options that include acute management as an outpatient. While efficacy and safety remain the princi- pal basis for choosing a therapy, the economic consequences of that choice should be considered as well. Objective: To estimate the average cost of various DVT management options from the perspective of US health payers. Design: Inpatient and outpatient management strategies were examined. Inpa- tient cases were identified by International Classification of Diseases, 9 th Edition, Clinical Modification codes and were classified into subgroups according to com- plication status. A cost estimate was developed by applying unit costs to the corresponding course of treatment. Cost estimates included initial acute care and that occurring in the following 6 months. Resource use profiles and unit costs were derived from several statewide inpatient, emergency room and ambulatory care databases supplemented by national fee schedules, published reports and peer-reviewed literature. All costs are reported in 1999 US dollars. Results: The mean 6-month treatment costs for inpatient management ranged from $US3906 to $US17 168, depending on complication status. For outpatient management, the cost ranged from $US2394 to $US3369, depending on fre- quency of low molecular weight heparin (LMWH) injection and need for profes- sional assistance. Conclusions: The management strategy selected for DVT has an important eco- nomic impact. Self-administered LMWH in a homecare setting results in the lowest cost. However, as some patients either cannot, or will not, be treated this way, it is important for decision makers to consider the costs of other strategies. ORIGINAL RESEARCH ARTICLE Pharmacoeconomics 2002; 20 (9): 603-615 1170-7690/02/0009-0603/$25.00/0 © Adis International Limited. All rights reserved. Deep vein thrombosis (DVT) is a common clin- ical condition affecting approximately two million patients in the US each year. [1] It requires prompt anticoagulation therapy to avoid complications, such as pulmonary embolism (PE). Until recently, a diagnosis of DVT would result in hospitalisation for several days and initial treatment with intrave- nous unfractionated heparin (UH) accompanied by