Estimation of the outpatient anticoagulation cost for pulmonary embolism in Greece.

Introduction: Pulmonary embolism (PE) exerts a significant morbidity and mortality burden which is associated with major financial cost for healthcare systems and patients. Our study aims to estimate the PE outpatient pharmaceutical cost in Greece. Methods: This retrospective study was based on data provided by the National Organization for the Provision of Health Services of Greece (NPHO) concerning the electronic prescriptions that were issued during the period 2013–2017 for PE patients. The data were associated with treatment from a cohort of 200 PE patients from the PE Outpatient Clinic of the University Hospital of Larissa. The collected data included the active substances prescribed, the dosage, the duration of treatment, and the pharmaceutical cost reimbursed from NPHO for each patient. Results: During the study period, 101426 electronic prescriptions were collected by NPHO. The estimated total cost of the PE outpatient treatment was €65910 in 2013 and increased to €1585552 in 2017. In 2013, the cost was €580794 for injectables and €7851 for acenocumarol, while in 2017 the cost of rivaroxaban was €1122086, the cost of apixaban was €119243, the cost of injectables was €321062, the cost of dabigatran was €4343 and the cost of acenocumarol was €19818. Conclusions: The PE outpatient pharmaceutical cost has increased in recent years. This is mainly attributed to the wide implementation of direct oral anticoagulants (DOACs) for the treatment of PE. No definite conclusions about the total PE cost can be drawn since DOACs require fewer laboratory visits which may reduce the additional costs. [ABSTRACT FROM AUTHOR]