Direct Healthcare Costs Associated with Oligoarticular Juvenile Idiopathic Arthritis at a Single Center

Oligoarticular juvenile idiopathic arthritis (JIA) is a common disease in pediatric rheumatology. The management of oligoarticular JIA can result in a considerable economic burden. This study is a four-year, retrospective cost identification analysis performed to determine the annual direct cost of care for patients with oligoarticular JIA and possible predictive clinical factors. Direct healthcare costs were defined as those associated with office visits, laboratory studies, hospital admissions, joint injections, medications, infusions, radiology tests, and emergency room visits. Disease characteristics and patient information included ANA status, gender, age at diagnosis, duration from diagnosis to initial visit during the study period, and whether uveitis had been diagnosed. We identified 97 patients with oligoarticular JIA eligible for the study. The median age of diagnosis was 4.3 years. Positive ANA were noted in 75% of patients. 34% of patients received at least one intra-articular steroid injection. 32% of patients were prescribed a biologic during the study period, predominantly with other medications, while 23% of patients received only NSAIDs. 20% of patients were prescribed oral steroids. The average total direct medical cost in this study per year for an oligoarticular JIA patient was $3929±6985. Medications accounted for 85% of annual direct medical costs. Clinic visits and laboratory testing accounted for 8% and 5%, respectively. Patient characteristics and demographics were tested for association with direct medical costs by the Wilcoxon rank sum test and Kruskal-Wallis test. Patients who were ANA positive had increased annual costs compared to patients who are ANA negative. ANA-positive patients were found to have statistically significant costs, particularly, in laboratory tests, procedural costs, radiology costs, and medication costs. The results reported here provide information when allocating healthcare resources and a better understanding of the economic impact oligoarticular JIA has on the United States healthcare system.

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What If the Influenza Vaccine Did Not Offer Such Variable Protection?

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa240 ◽

2020 ◽

Vol 222 (7) ◽

pp. 1138-1144 ◽

Cited By ~ 1

Author(s):

Sarah M Bartsch ◽

Elizabeth A Mitgang ◽

Gail Geller ◽

Sarah N Cox ◽

Kelly J O’Shea ◽

...

Keyword(s):

Influenza Vaccine ◽

Compartment Model ◽

Medical Costs ◽

The United States ◽

Individual Factors ◽

Policy Makers ◽

Direct Medical Costs ◽

Productivity Losses ◽

Potential Impact ◽

The Impact

Abstract Background The protection that an influenza vaccine offers can vary significantly from person to person due to differences in immune systems, body types, and other factors. The question, then, is what is the value of efforts to reduce this variability such as making vaccines more personalized and tailored to individuals. Methods We developed a compartment model of the United States to simulate different influenza seasons and the impact of reducing the variability in responses to the influenza vaccine across the population. Results Going from a vaccine that varied in efficacy (0–30%) to one that had a uniform 30% efficacy for everyone averted 16.0–31.2 million cases, $1.9–$3.6 billion in direct medical costs, and $16.1–$42.7 billion in productivity losses. Going from 0–50% in efficacy to just 50% for everyone averted 27.7–38.6 million cases, $3.3–$4.6 billion in direct medical costs, and $28.8–$57.4 billion in productivity losses. Going from 0–70% to 70% averted 33.6–54.1 million cases, $4.0–$6.5 billion in direct medical costs, and $44.8–$64.7 billion in productivity losses. Conclusions This study quantifies for policy makers, funders, and vaccine developers and manufacturers the potential impact of efforts to reduce variability in the protection that influenza vaccines offer (eg, developing vaccines that are more personalized to different individual factors).

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PMH7: CHANGES IN SCHIZOPHRENIA-RELATED TOTAL DIRECT MEDICAL COSTS FOLLOWING INITIATION OF OLANZAPINE OR RISPERIDONE IN A PRIVATELY INSURED POPULATION IN THE UNITED STATES

Value in Health ◽

10.1016/s1098-3015(11)71616-3 ◽

2001 ◽

Vol 4 (6) ◽

pp. 453

Author(s):

P Russo ◽

MW Smith ◽

M Namjoshi

Keyword(s):

United States ◽

Medical Costs ◽

The United States ◽

Direct Medical Costs ◽

Privately Insured

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Abstract 144: Cost of Cardiovascular Disease Episodes among Patients with Hypertension

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.8.suppl_2.144 ◽

2015 ◽

Vol 8 (suppl_2) ◽

Author(s):

Alejandro Arrieta ◽

Nan Qiao ◽

John R Woods ◽

Stephen J Jay ◽

Emir Veledar ◽

...

Keyword(s):

Age Groups ◽

Medical Costs ◽

Insurance Claims ◽

Insurance Plan ◽

Total Direct Medical Cost ◽

Hypertensive Patients ◽

Direct Medical Costs ◽

Before And After ◽

Insurance Claims Data ◽

Ischemic Attack

Background: Because of its high prevalence and direct contribution to cardiovascular diseases (CVD), hypertension is among the most expensive components of CVD, representing nearly 50% of the total direct medical cost of CVD in the U.S. Yet, little is known about the per-patient cost of CVD episodes among hypertensives. Methods: This study used insurance claims data from over 16,000 individuals diagnosed with hypertension and enrolled in a private health insurance plan between 2008 and 2010. About one million medical and pharmacy insurance claims generated by these hypertensive patients were extracted for the analysis. Six CVD were included in the study: Myocardial infarction (MI), unstable angina (UA), stable angina (SA), transient ischemic attack (TIA), stroke, and congestive heart failure (CHF). Direct medical costs (ambulatory, emergency, hospital visits and medications) for each CVD were obtained on a weekly basis over 26 weeks before and after a recorded CVD episode. Per-patient direct medical costs were estimated by taking a before-after difference in cost, corrected by censoring due to deaths and insurance plan exits. Average costs were segmented by age groups (40-64 and 65 or over). Costs were adjusted to 2010 U.S. dollars. Results: The most expensive CVD episode among hypertensives was UA ($17,704; 95%CI $11,632-22,644), followed by MI ($13,480; 95%CI $8,328-18,752), stroke ($13,223; 95%CI $8,080-17,556), CHF ($12,462; 95%CI $9,734-15,335), SA ($6,991; 95%CI $4,178-9,947), and TIA ($5,787; 95%CI $2,671-9,670). CVD costs converged to pre-event cost levels within the next 4 to 14 months after the recorded CVD episode. Some CVD costs (CHF, UA, MI) rose 1 to 3 weeks before the recorded event, while others (stroke, TIA, SA) clearly started during the week of the recorded event (see Figure 1 comparing CHF and stroke). For the former, pre-event costs explained up to 30% of total costs. Conclusions: Cost estimates of CVD episodes among hypertensive patients are consistent with results from the scarce literature in this area. Moreover, our study finds evidence of increased medical resource utilization weeks before the recording of the CVD episode. Omitting these pre-event costs leads to an underestimate of the true costs of CVD.

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The Clinical and Economic Burden of Norovirus Gastroenteritis in the United States

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa292 ◽

2020 ◽

Vol 222 (11) ◽

pp. 1910-1919 ◽

Cited By ~ 1

Author(s):

Sarah M Bartsch ◽

Kelly J O’Shea ◽

Bruce Y Lee

Keyword(s):

United States ◽

Economic Burden ◽

Computational Simulation ◽

Medical Costs ◽

The United States ◽

School Work ◽

Direct Medical Costs ◽

Productivity Losses ◽

Incidence Estimate ◽

Norovirus Gastroenteritis

Abstract Background Although norovirus outbreaks periodically make headlines, it is unclear how much attention norovirus may receive otherwise. A better understanding of the burden could help determine how to prioritize norovirus prevention and control. Methods We developed a computational simulation model to quantify the clinical and economic burden of norovirus in the United States. Results A symptomatic case generated $48 in direct medical costs, $416 in productivity losses ($464 total). The median yearly cost of outbreaks was $7.6 million (range across years, $7.5–$8.2 million) in direct medical costs, and $165.3 million ($161.1–$176.4 million) in productivity losses ($173.5 million total). Sporadic illnesses in the community (incidence, 10–150/1000 population) resulted in 14 118–211 705 hospitalizations, 8.2–122.9 million missed school/work days, $0.2–$2.3 billion in direct medical costs, and $1.4–$20.7 billion in productivity losses ($1.5–$23.1 billion total). The total cost was $10.6 billion based on the current incidence estimate (68.9/1000). Conclusion Our study quantified norovirus’ burden. Of the total burden, sporadic cases constituted >90% (thus, annual burden may vary depending on incidence) and productivity losses represented 89%. More than half the economic burden is in adults ≥45, more than half occurs in winter months, and >90% of outbreak costs are due to person-to-person transmission, offering insights into where and when prevention/control efforts may yield returns.

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