Economic evaluation of outpatient specialized models of care versus usual care for venous thromboembolism management– A systematic review

Venous thromboembolism (VTE) is a major cause of cardiovascular-related mortality and morbidity worldwide. The clinical and economic burden of the disease remains substantial. We conducted a systematic review (SR) to identify and consolidate economic evaluation studies which compared specialized outpatient thrombosis and anticoagulation care models to usual care for the management of VTE. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and PRISMA literature search extension (PRISMA-S) guidelines were followed. A comprehensive search of PubMed, Embase, Cochrane Library, and CINAHL from inception to March 22, 2025 was completed. Two reviewers independently screened titles and abstracts assessed full text articles for inclusion, and performed data extraction. Discrepancies were resolved through team discussion. A quality assessment was performed using the Quality of Health Economic Studies checklist. Findings were then summarized using narrative synthesis methods. Twenty-five articles met the inclusion criteria, including 10 full economic evaluations (four high quality studies, four moderate quality studies, and two low quality studies) and 15 partial economic evaluation studies (four moderate quality studies and 11 low quality studies) . Compared to usual care, specialized outpatient thrombosis and anticoagulation care models were associated with healthcare cost savings (ranging from 1,374 CAD to 2,760,118 CAD), had similar or improved clinical outcomes, and were deemed cost-effective (ICER of -4 CAD per % TTR, 21,602 CAD per QALY, and 29,466 CAD). There is a paucity of high-quality economic evaluation studies that compare specialized outpatient thrombosis and anticoagulation care models to usual care for patients with VTE. Further research based on current clinical practice, which includes comprehensive, specialized thrombosis and anticoagulation that incorporate contemporary treatments is needed. • Limited high-quality economic data exists for the most cost-effective model of care for patients with VTE. • Available evidence suggests specialized care models for VTE have improved clinical outcomes and healthcare savings. • Further economic evaluation reflecting current clinical practice for VTE is needed.