OBJECTIVES: Aggravated, iatrogenic, venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is one of the main causes of preventable in-hospital morbidity and mortality. In addition to its patient burden, VTE imposes a substantial economic burden on healthcare systems. In many countries, though, this burden remains unknown. This analysis quantified the burden of VTE across ten different countries.

METHODS: The study was undertaken in Australia, Brazil, China, France, Mexico, South Korea, Spain, Taiwan, Thailand, and the UK. The GATHER guideline was followed, with expert interviews and a systematic literature review informing the burden of disease model. Prophylaxis decisions were modelled with a decision tree, with VTE development and progression evaluated using a Markov model. The five most important clinical areas for VTE per country were identified by clinician survey. The main outcomes per clinical area and per country per annum were: total cost burden, quality-adjusted life years (QALYs), and hospital days due to VTE.

RESULTS: Key areas for iatrogenic VTE included surgeries (orthopedic, oncology, cardiology, obstetrics/gynecology [obgyn]) and long-term ICU. In these areas there were an estimated 9,179,228 VTE events. On average the cost burden of VTE was equal to 0.10% of each country’s GDP. The highest total cost of VTE was found in China: $25,004,681,545. The clinical areas with the highest total cost of VTE included obgyn, long-term ICU, and orthopedics. In total, there were 22,784,555 additional hospital days required due to VTE. Total QALYs lost (per 100,000 population) due to VTE ranged from 13 in South Korea to 414 in China. In general, higher use of prophylaxis resulted in a lower burden of VTE.

CONCLUSIONS: VTE places a substantial burden on all healthcare systems assessed here. Increased use of VTE prophylaxis in compliance with care guidelines could help to reduce this burden.