The cost of outpatient venous thromboembolism prophylaxis following lower limb injuries

C. U. Menakaya, N. Pennington, N. Muthukumar, J. Joel, A. J. Ramirez Jimenez, C. J. Shaw, A. Mohsen


This paper reports the cost of outpatient venous thromboembolism (VTE) prophylaxis following 388 injuries of the lower limb requiring immobilisation in our institution, from a total of 7408 new patients presenting between May and November 2011. Prophylaxis was by either self-administered subcutaneous dalteparin (n = 128) or oral dabigatran (n = 260). The mean duration of prophylaxis per patient was 46 days (6 to 168). The total cost (pay and non-pay) for prophylaxis with dalteparin was £107.54 and with dabigatran was £143.99. However, five patients in the dalteparin group required nurse administration (£23 per home visit), increasing the cost of dalteparin to £1142.54 per patient. The annual cost of VTE prophylaxis in a busy trauma clinic treating 12 700 new patients (2010/11), would be £92 526.33 in the context of an income for trauma of £1.82 million, which represents 5.3% of the outpatient tariff.

Outpatient prophylaxis in a busy trauma clinic is achievable and affordable in the context of the clinical and financial risks involved.

Cite this article: Bone Joint J 2013;95-B:673–7.


  • The authors would like to thank the VTE nurses; Y. Hadland, E. Bush, M. Ward and orthopaedic outpatient’s sister, N. Day and D. Braithwaite for setting up the trust VTE prophylaxis database.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    This article was primary edited by S. Hughes and first-proof edited by G. Scott.

  • Received July 27, 2012.
  • Accepted December 28, 2012.
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