The cost-effectiveness of point-of-care D-dimer tests compared with a laboratory test to rule out deep venous thrombosis in primary care

Objective: Point-of-care (POC) D-dimer tests have been developed to exclude deep venous thrombosis quickly and on the spot, but are known to have lower sensitivity compared with laboratory-based tests. Their cost-effectiveness is still unknown. Methods: We updated and extended a previously published Markov model to assess the cost-effectiveness of POC D-dimer tests (Simplify', Cardiac', Triage' and Nycocard') compared with a laboratory-based latex assay to diagnose deep venous thrombosis in primary care. Results: The Laboratory' strategy resulted in 6.986 quality-adjusted life years at the cost of Euro8354 per patient. All POC D-dimer tests resulted in health outcomes similar to the Laboratory' strategy. The Simplify' strategy maximized cost savings (-Euro155 [95% CI: -Euro246 to -Euro83]). Conclusions: POC D-dimer tests yield similar health outcomes as laboratory-based testing procedures but can be performed more easily and at lower costs. Therefore, these tests are an alternative to laboratory-based testing and might be considered for exclusion of deep venous thrombosis in primary care.