The costs of venous disorders in the Netherlands and the cost-effectiveness of compression stockings

The objective of this study was to estimate the cost-effectiveness of compression stockings in patients with symptomatic deep-vein thrombosis (DVT) to prevent the post-thrombotic syndrome (PTS) in comparison with no stockings. The economic evaluation was based on a decision analytic model using the results of a randomised clinical trial, which indicated that the application of compression stockings in patients with a first episode of a proximal DVT reduces the incidence of the PTS significantly. We estimated direct medical costs by combining expert opinion on resource use with Dutch tariffs (1995). Cost-effectiveness was assessed by evaluating the costs per case of PTS prevented and was based on a time horizon of 6.3 years. Both costs and effects were discounted at 5%. The cost-effectiveness was estimated to be $US 786 per PTS prevented, assuming that patients wore compression stockings during the entire period of follow-up. Assuming that patients only wear stockings during the first two years after a deep-vein thrombosis, the cost-effectiveness was estimated to be minus $ 1008 per case prevented. We conclude that the application of compression stockings after a DVT is cost-effective.