OBJECTIVES: Cancer increased the risk of gaining cancer-associated thrombosis (CAT). CAT is common and can occur spontaneously. Low molecular weight heparin (LMWH) is a standard care based on international guidelines. Despite being one of common cancer related complication, there are only a few studies on the disease and economic burden of CAT globally peculiarly in Asian country. The aim of this study was to find the prevalence of CAT among solid tumours and to calculate the associated total health utilization costs in Malaysia.

METHODS: Patient’s data was collected cross-sectionally under real-world condition in National Cancer Institute, Malaysia. In the analysis, newly diagnosed n=12,093 patients with solid tumour malignancy who received any mode of treatment between 2015 and 2019 were included. Patient characteristics and treatment used were catalogued. The total health outlay as a share of budget was congregate from procurement record and annual institution report.

RESULTS: 12,093 solid tumour cancer patients were included in the analysis. n=688 patients (5.7%) developed a CAT and treated either with enoxaparine, fondaparinux or rivaroxaban. The highest incidence was documented in year 2016 (7.6%) while the lowest were 4.5% in 2015. In total n=331 treated with fondaparinux (48.1%), n=310 received enoxaparine (45.1%), and n=47 with rivaroxaban (6.8%) were found. Total health expenditure for treatment of CAT over period of 5years was MYR2777280.20 (n=688) with mean costs in term of treatment acquisition per patients per year was MYR4036.80. Rivaroxaban was associated with the cheapest cost per patient per year (MYR811.10) compared with other interventions. The percentage of health utilization per budget allocation was around 2.1 to 5.2% (mean=3.3%) of total institution drugs budget.

CONCLUSIONS: The economic burden of CAT in Malaysia is sizable. Higher budget utilization for CAT will upset budget of effective anti-cancer therapy. From provider perspective, the most cost-effective treatment needed to reduce financial burden.