Impact of Depression Onset and Treatment on the Trend of Annual Medical Costs in Japan: An Exploratory, Descriptive Analysis of Employer-Based Health Insurance Claims Data

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

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Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

BMC Neurology ◽

10.1186/s12883-019-1534-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Izumi Kawachi ◽

Shuichi Okamoto ◽

Mariko Sakamoto ◽

Hiroyuki Ohta ◽

Yusuke Nakamura ◽

...

Keyword(s):

Multiple Sclerosis ◽

Health Insurance ◽

Medical Cost ◽

Claims Data ◽

Medical Costs ◽

Insurance Claims ◽

Total Medical Cost ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results Four thousand three hundred seventy-four MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from ¥87,640 (US$787.7 or €723.0 as of May 2017) to ¥102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from ¥23,039 (US$207.1 or €190.1) to ¥51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (¥424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (¥119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. Although this study does not show the direct causality between DMT and reduction of relapse rates/fewer hospitalizations among MS patients, a reduction in hospital costs has been revealed concomitantly with the increasing prevalence of DMT.

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Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

10.21203/rs.2.9293/v1 ◽

2019 ◽

Author(s):

Izumi Kawachi ◽

Shuichi Okamoto ◽

Mariko Sakamoto ◽

Hiroyuki Ohta ◽

Yusuke Nakamura ◽

...

Keyword(s):

Health Insurance ◽

Medical Cost ◽

Claims Data ◽

Medical Costs ◽

Insurance Claims ◽

Total Medical Cost ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims ◽

Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

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Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

10.21203/rs.2.9293/v2 ◽

2019 ◽

Author(s):

Izumi Kawachi ◽

Shuichi Okamoto ◽

Mariko Sakamoto ◽

Hiroyuki Ohta ◽

Yusuke Nakamura ◽

...

Keyword(s):

Health Insurance ◽

Medical Cost ◽

Claims Data ◽

Medical Costs ◽

Insurance Claims ◽

Total Medical Cost ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims ◽

Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

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Medical Costs and Hospitalizations Among Patients with Depression Treated with Adjunctive Atypical Antipsychotic Therapy: An Analysis of Health Insurance Claims Data

Annals of Pharmacotherapy ◽

10.1345/aph.1r622 ◽

2013 ◽

Vol 47 (7-8) ◽

pp. 933-945 ◽

Cited By ~ 7

Author(s):

Rachel Halpern ◽

Anagha Nadkarni ◽

Iftekhar Kalsekar ◽

Hiep Nguyen ◽

Rui Song ◽

...

Keyword(s):

Health Insurance ◽

Atypical Antipsychotic ◽

Claims Data ◽

Medical Costs ◽

Insurance Claims ◽

Antipsychotic Therapy ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims

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Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

10.21203/rs.2.9293/v4 ◽

2019 ◽

Author(s):

Izumi Kawachi ◽

Shuichi Okamoto ◽

Mariko Sakamoto ◽

Hiroyuki Ohta ◽

Yusuke Nakamura ◽

...

Keyword(s):

Multiple Sclerosis ◽

Health Insurance ◽

Medical Cost ◽

Claims Data ◽

Medical Costs ◽

Insurance Claims ◽

Total Medical Cost ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. Although this study does not show the direct causality between DMT and reduction of relapse rates/fewer hospitalizations among MS patients, a reduction in hospital costs has been revealed concomitantly with the increasing prevalence of DMT.

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The effect of Asian dust on asthma by socioeconomic status using national health insurance claims data in Korea

Inhalation Toxicology ◽

10.3109/08958378.2015.1123331 ◽

2016 ◽

Vol 28 (1) ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Yoon-Sung Park ◽

Jeong-Hee Kim ◽

Hae-Ji Jang ◽

Yoon-Hee Tae ◽

Dae Hyun Lim

Keyword(s):

Socioeconomic Status ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Claims Data ◽

Asian Dust ◽

Insurance Claims ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims

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Decomposition of outpatient health care spending by disease - a novel approach using insurance claims data

BMC Health Services Research ◽

10.1186/s12913-021-07262-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Stucki ◽

Janina Nemitz ◽

Maria Trottmann ◽

Simon Wieser

Keyword(s):

Health Care ◽

Health Insurance ◽

Claims Data ◽

Health Care Spending ◽

Insurance Claims ◽

Diagnostic Coding ◽

Insurance Claims Data ◽

Health Insurance Claims Data ◽

Health Insurance Claims ◽

Disease Specific

Abstract Background Decomposing health care spending by disease, type of care, age, and sex can lead to a better understanding of the drivers of health care spending. But the lack of diagnostic coding in outpatient care often precludes a decomposition by disease. Yet, health insurance claims data hold a variety of diagnostic clues that may be used to identify diseases. Methods In this study, we decompose total outpatient care spending in Switzerland by age, sex, service type, and 42 exhaustive and mutually exclusive diseases according to the Global Burden of Disease classification. Using data of a large health insurance provider, we identify diseases based on diagnostic clues. These clues include type of medication, inpatient treatment, physician specialization, and disease specific outpatient treatments and examinations. We determine disease-specific spending by direct (clues-based) and indirect (regression-based) spending assignment. Results Our results suggest a high precision of disease identification for many diseases. Overall, 81% of outpatient spending can be assigned to diseases, mostly based on indirect assignment using regression. Outpatient spending is highest for musculoskeletal disorders (19.2%), followed by mental and substance use disorders (12.0%), sense organ diseases (8.7%) and cardiovascular diseases (8.6%). Neoplasms account for 7.3% of outpatient spending. Conclusions Our study shows the potential of health insurance claims data in identifying diseases when no diagnostic coding is available. These disease-specific spending estimates may inform Swiss health policies in cost containment and priority setting.

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