scholarly journals THU0546 HEALTHCARE COSTS OF NOT ACHIEVING REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 513.2-513
Author(s):  
M. Bergman ◽  
L. Zhou ◽  
P. Patel ◽  
R. Sawant ◽  
J. Clewell ◽  
...  
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Index Date ◽  
Healthcare Resource ◽  
Medical Costs ◽  
Direct Costs ◽  
Healthcare Resource Use ◽  
Outpatient Visits ◽  
Number Of Visits ◽  
The Impact

Background:Guidelines recommend sustained remission as a treatment goal for patients with rheumatoid arthritis (RA). However, only one-third of patients are known to achieve this goal with current treatments. A few studies have evaluated the impact of remission in a real-world setting, but evidence is limited to the elderly population.Objectives:To understand the impact of remission on healthcare costs by comparing overall and RA-related direct healthcare costs and resource use in patients with RA who maintain vs those who do not maintain remission using a real-world database.Methods:Data for this retrospective cohort study were derived from Optum electronic health records linked to claims from commercial and Medicare Advantage health plans in the United States. Patients with ≥2 diagnoses for RA, ≥1 Disease Activity Score 28 (DAS28-CRP/ESR) or Routine Assessment of Patient Index Data 3 (RAPID3) measurement, and continuous medical and pharmacy coverage 6 months before and 1 year after the index date were included. Two cohorts were created: remission and non-remission. Remission was defined as DAS28 <2.6 or RAPID3 ≤3.0. In the remission cohort, the index date was defined as the first date remission was achieved. In the non-remission cohort, the index date was defined as the first date of DAS28 or RAPID3 measurement. Outcomes were all-cause and RA-related total, medical, and prescription costs; healthcare resource use (number of inpatient, emergency department [ED], outpatient, and other visits); and number of prescriptions within 1 year of index date. A weighted generalized linear model and binomial regression were used to estimate adjusted annual direct costs and healthcare resource use, respectively. Confounding between cohorts due to age, sex, race and comorbidities using the Elixhauser index was controlled for in the models.Results:A total of 335 patients with RA (remission cohort: 125; non-remission cohort: 210) met the study inclusion criteria. Annual all-cause total direct costs in the remission cohort were significantly less than in the non-remission cohort ($30,427 vs $38,645, respectively; cost ratio (CR)=0.79; 95% CI: 0.63, 0.99). All-cause medical costs were significantly lower in the remission cohort than in the non-remission cohort (Figure 1); furthermore, among all-cause medical costs, outpatient visit costs were significantly lower in the remission than in the non-remission cohort. All-cause resource use (mean number of visits) was less in the remission vs non-remission cohort: inpatient (0.23 vs 0.63; visit ratio (VR)=0.36; 95% CI: 0.19, 0.70), ED (0.36 vs 0.77; VR=0.47; 95% CI: 0.30, 0.74), and outpatient visits (20.7 vs 28.5; VR=0.73; 95% CI: 0.62, 0.86). Annual RA-related total direct costs were similar in both cohorts (Figure 2); however, RA-related medical costs were numerically lower in the remission vs non-remission cohort ($8,594 vs $10,002, respectively; CR=0.86; 95% CI: 0.59, 1.25). RA-related resource use (mean number of visits) was less in the remission vs non-remission cohort: inpatient (0.15 vs 0.22; VR=0.67; 95% CI: 0.35, 1.30), ED (0.04 vs 0.13; VR=0.31; 95% CI: 0.10, 0.95), and outpatient visits (5.4 vs 7.4; VR=0.72; 95% CI: 0.58, 0.91).Conclusion:Significant economic burden was associated with patients who did not maintain remission compared with those who maintained remission. Although outpatient visits were the driver of medical costs in both groups studied in this analysis, the contribution of outpatient visits was greater among those who did not maintain remission.Acknowledgments:Financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. All authors contributed to the development of the publication and maintained control over the final content. Medical writing services were provided by Joann Hettasch of JK Associates Inc., a member of the Fishawack Group of Companies, and funded by AbbVie.Disclosure of Interests:Martin Bergman Shareholder of: Johnson & Johnson – stockholder, Consultant of: AbbVie, BMS, Celgene Corporation, Genentech, Janssen, Merck, Novartis, Pfizer, Sanofi – consultant, Speakers bureau: AbbVie, Celgene Corporation, Novartis, Pfizer, Sanofi – speakers bureau, Lili Zhou Shareholder of: AbbVie, Employee of: AbbVie, Pankaj Patel Shareholder of: AbbVie, Employee of: AbbVie, Ruta Sawant Shareholder of: AbbVie, Employee of: AbbVie, Jerry Clewell Shareholder of: AbbVie, Employee of: AbbVie, Namita Tundia Shareholder of: AbbVie, Employee of: AbbVie

scholarly journals Direct Costs And Healthcare Resource Use Associated With Advanced Melanoma In Portugal

2015 ◽  
Vol 18 (7) ◽  
pp. A466
Author(s):  
F Lopes ◽  
MJ Passos ◽  
A Raimundo ◽  
PA Laires
Keyword(s):  
Resource Use ◽  
Healthcare Resource ◽  
Direct Costs ◽  
Advanced Melanoma ◽  
Healthcare Resource Use

scholarly journals P685 Healthcare resource use associated with ferric maltol and IV iron treatment for iron deficiency anaemia in patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S558-S558 ◽  
Author(s):  
S Howaldt ◽  
I Jacob ◽  
M Sampson ◽  
F Akriche
Keyword(s):  
Inflammatory Bowel Disease ◽  
Resource Use ◽  
Iron Deficiency Anaemia ◽  
Healthcare Resource ◽  
Healthcare Resource Use ◽  
Deficiency Anaemia ◽  
Outpatient Visits ◽  
Iv Iron ◽  
Additional Costs ◽  
Inflammatory Bowel

Abstract Background Iron deficiency anaemia (IDA) is common in patients with inflammatory bowel disease (IBD). IDA imposes a substantial economic burden on healthcare payers resulting primarily from increased medical costs and increased rates of hospital admission. Most guidelines recommend oral iron as first-line treatment, with IV iron if oral supplementation is ineffective or poorly tolerated. Intolerance to ferrous (Fe2+) oral iron is common in patients with IBD. Ferric maltol (FM), a stable oral complex of ferric (Fe3+) iron and maltol, is designed to reduce exposure to elemental iron and thus limit gastrointestinal damage. This analysis compares the Healthcare resource use (HCRU) associated with oral FM and IV ferric carboxymaltose (FCM) treatment. Methods Patients with IBD and IDA (haemoglobin [Hb] ≥8.0 g/dl and ≤11.0 g/dl for women or ≥8.0 g/dl and ≤12.0 g/dl for men, and ferritin &lt;30 ng/ml or ferritin &lt;100 ng/ml with transferrin saturation &lt;20%) were randomised to FM (30 mg b.i.d) or IV FCM (as per local SmPC) in an open-label, Phase 3b non-inferiority study. The primary endpoint was Hb responder rate (proportion of patients achieving a ≥2 g/dl increase or normalisation of Hb at week 12); the margin for non-inferiority was 20%. HCRU was assessed based on the total costs of iron therapy (including drug costs and administration), and the number of hospital/outpatient visits during the initial 12-week study period. Costs of IV FCM and FM were applied to a German setting. Results 250 patients were randomised: 125 to FM and 125 to IV FCM. The non-inferiority endpoint was met. Mean (standard deviation; SD) total treatment costs per patient in the FM and IV FCM arms were €302.27 (€80.68) and €489.37 (€147.19) respectively. Eighty-seven per cent of FM patients were still receiving treatment at week 12, and 45% and 36% of IV FCM patients required a repeat course of IV iron at weeks 4 and 12, respectively. The mean (SD) number of hospital/outpatient visits during the study period for patients receiving IV FCM was 2.30 (0.88) and the total dose of IV FCM received was 1621 mg (491 mg). Conclusion Total per patient drug costs were approximately 1.6 times higher for treatment with IV FCM than FM. The total cost of IV FCM is not only influenced by the higher drug cost, but additional costs associated with IV administration which was required to be carried out in a hospital or outpatient setting. FM has no additional costs or resource use associated with administration and is, therefore, less of a burden on local healthcare systems. FM is associated with non-inferior efficacy and substantially lower HCRU than IV FCM, and may provide a cost-effective oral alternative to IV iron in patients with IBD.

scholarly journals Healthcare resource use in patients of the Australian Transition Care Program

2015 ◽  
Vol 39 (4) ◽  
pp. 411 ◽  
Author(s):  
Tracy A. Comans ◽  
Nancye M. Peel ◽  
Ian D. Cameron ◽  
Leonard Gray ◽  
Paul A. Scuffham
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Hospital Costs ◽  
Care Program ◽  
Healthcare Resource Use ◽  
Admission Rates ◽  
Care Recipients ◽  
Transition Care ◽  
The Cost

Objective The aim of the present study was to describe, from the perspective of the healthcare funder, the cost components of the Australian Transition Care Program (TCP) and the healthcare resource use and costs for a group of transition care clients over a 6-month period following admission to the program. Methods A prospective cohort observational study of 351 consenting patients entering community-based transition care at six sites in two states in Australia from November 2009 to September 2010 was performed. Patients were followed up 6 months after admission to the TCP to ascertain current living status and hospital re-admissions over the follow-up period. Cost data were collected by transition care teams and from administrative data (hospital and Medicare records). Results The TCP provides a range of services with most costs attributed to provision of personal care support, case management, physiotherapy and occupational therapy. Most healthcare costs up to 6 months after transition care admission were incurred from the hospital admission leading to transition care and from re-admissions. Orthopaedic conditions incurred the highest costs, with many of these for elective procedures and others resulting from falls. Hospital re-admission rates in the present study were 10% lower than in a previous evaluation of the TCP. Over 6 months, approximately 40% of patients in the study were re-admitted to hospital at an average cost of A$7038. Conclusions Although the cost of the TCP is relatively high, it may have some impact on reducing hospital re-admissions and preventing or delaying residential care admissions. What is known about the topic? A majority of healthcare costs occur in older age. What does this paper add? Hospital costs, both initial and re-admissions, are the major contributor to healthcare costs in transition care recipients. Orthopaedic conditions are the most expensive to treat and neurological conditions are the most variable. What are the implications for practitioners? Reducing the length of hospitalisation and reducing re-admissions for older frail people is a key economic concern for health services. Services such as the TCP aim to do both; however, the evidence that this is effective is limited. Streamlining referrals to transition care to enable earlier access and involving the transition care provider in re-admission decisions may help reduce healthcare costs in future.

Medical costs and healthcare resource use in patients with lupus nephritis and neuropsychiatric lupus in an insured population

2013 ◽  
Vol 16 (4) ◽  
pp. 500-509 ◽  
Author(s):  
Daniel E. Furst ◽  
Ann Clarke ◽  
Ancilla W. Fernandes ◽  
Tim Bancroft ◽  
Kavita Gajria ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Resource Use ◽  
Healthcare Resource ◽  
Medical Costs ◽  
Neuropsychiatric Lupus ◽  
Healthcare Resource Use
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