Abstract 240: Cardiovascular-related Healthcare Resource Utilization and Costs among Patients with Hypertension Switching From Metoprolol to Nebivolol

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Stephanie Chen ◽  
An-Chen Fu ◽  
Rahul Jain ◽  
Hiangkiat Tan
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Beta Blockers ◽  
Medical Costs ◽  
Healthcare Resource Utilization ◽  
Study Cohort ◽  
Research Database ◽  
Branded Drug ◽  
Pharmacy Claims ◽  
Post Period

Background: Metoprolol is a commonly prescribed β-blocker for hypertension in the US. Evidence suggests that the vasodilating β1-blocker, nebivolol, is superior to non-vasodilating beta-blockers, such as metoprolol, in lowering central blood pressure, an effect which is thought to be highly correlated to future cardiovascular (CV) risk. The aim of this study was to evaluate CV-related healthcare resource utilization (HCRU) and costs before and after patients switched from metoprolol to nebivolol for hypertension treatment. Methods: This retrospective study utilized medical and pharmacy claims from HealthCore-Integrated-Research-Database with 14 US commercial health plans representing over 33 million lives. The study cohort included only patients who were initially taking metoprolol for at least 6 months (pre-period) and then switched to nebivolol and remained on it for at least 6 months (post-period). The date of switching to nebivolol between 1/1/ 2008 and 12/31/2012 was defined as the index date. Patients were excluded if they had angina, myocardial infarction and congestive heart failure (compelling indications for metoprolol but not for nebivolol); unstable regimen of background antihypertensive medication at the drug class level; or did not have continuous health plan enrollment during these two periods. CV-related HCRU (per-100 patient-per-month) and costs (per-patient-per-month (PPPM)) were calculated for pre- and post- periods respectively by type of service - hospitalizations (INP), emergency room (ER) visits, and outpatient (OP) visits. Bootstrapping t-test was used to compare the differences of HCRU and costs between these two periods. Results: There were 765 patients included in the study with mean age 55(±11)years, 59% males and mean Deyo-Charlson Comorbidity Index (DCI) score of 0.5(±0.9). Relative to pre-period, the number of CV-related ER visits and CV-related OP visits per-100 patient-per-month were significantly lower in the post-period (ER: 0.17±1.88 vs.0.04±0.84, p=0.012; OP: 9.2±19.9 vs. 6.7±17.5, p<0.001). No differences were observed in number of CV-related INP visits. Additionally, relative to the pre-period, the ER cost and the total CV-related medical were significantly lower in the post-period (ER: $6 ±$78 vs. $1±$27 PPPM, p=0.028; total CV-related medical costs: $94±$526 vs. $54±$266 PPPM, p=0.020). There were no differences found in INP or OP costs. Conclusions: This study suggests that hypertensive patients switching from metoprolol to nebivolol have lower CV-related ER and OP visits as well as lower total CV-related medical costs, despite higher pharmacy costs after switching from a generic to a branded drug. Further studies are needed to identify these key drivers.

scholarly journals Healthcare resource utilization and costs associated with hyperkalemia in a large managed care population

2021 ◽  
Author(s):  
Ajay Sharma ◽  
Paula J Alvarez ◽  
Steven D Woods ◽  
Jeanene Fogli ◽  
Dingwei Dai
Keyword(s):  
Resource Utilization ◽  
Health Plan ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Care Physician ◽  
Study Cohort ◽  
Administrative Claims ◽  
Improvement Program ◽  
Renin Angiotensin ◽  
Ckd Stage

Abstract Background Hyperkalemia is a serious metabolic condition and can lead to life-threatening cardiac arrhythmias and sudden death. Guideline-directed medications that affect the renin-angiotensin-aldosterone axis can increase serum potassium and may limit their use. Hyperkalemia has been shown to drive healthcare resource utilization (HRU) and costs for patients with cardiorenal conditions. Objectives To describe hyperkalemic patient characteristics and quantify patient HRU and costs relative to normokalemic patients from a large US health plan. Methods A retrospective cohort study that identified and evaluated a hyperkalemic patient population from a large administrative claims database. The observation period was 1 January 2015 to 31 May 2018, with a 1-year follow-up period after the index date (the earliest service/claim with evidence of hyperkalemia). Primary patient outcomes included inpatient admissions, emergency department (ED) visits, primary care physician (PCP)/specialist visits, length of stay (LOS) and associated medical and pharmacy costs. This hyperkalemic cohort was stratified by renin-angiotensin-aldosterone system inhibitor (RAASi) utilization and chronic kidney disease (CKD) stage for the economic analysis. Key findings 86,129 adult patients with hyperkalemia were evaluated in the study cohort (median age: 69 years). There were more males [45,155 (52%)], with the majority of patients located in the Southern United States [45,541 (51%)] and a 70/30 split of Medicare to a commercial health plan. Most patients had CKD, hypertension and hyperlipidemia; ≥80% of the patients had ≥4 comorbidities. Over 40% of patients were not receiving RAASi therapy, and potassium binder use was low (&lt;5%). Patients using optimal-dose RAASi with proportion of days covered ≥80% were observed to have the lowest HRU for inpatient admissions, ED and PCP visits and LOS days. Conclusions Hyperkalemia is associated with substantial HRU and costs. The development of a quality improvement program structured around the management of hyperkalemia in individuals with heart failure, diabetes and/or CKD may be necessary.

scholarly journals Real-world treatment, clinical outcomes and healthcare resource utilization among persons with hemophilia A by age

2021 ◽  
Author(s):  
Eleanor O Caplan ◽  
Anisha M Patel ◽  
Richard W DeClue ◽  
Marina Sehman ◽  
Daniel Cornett ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Real World ◽  
Claims Data ◽  
Hemophilia A ◽  
Healthcare Resource ◽  
Bleeding Event ◽  
Healthcare Resource Utilization ◽  
Research Database ◽  
Medicare Advantage ◽  
Prescription Drug Plans

Aim: Examine real-world characteristics, treatment patterns, and outcomes among treated persons with hemophilia A (PwHA) stratified by age. Patients & methods: This study utilized US claims data from 1 January 2007–31 July 2018 from the Humana Research Database. Unadjusted comparisons were conducted across PwHA (<18, 18–55, 56–89 years) enrolled in commercial or Medicare Advantage Prescription Drug plans. Results: A total of 294 PwHA were identified; 21.1% experienced ≥1 bleeding event, and 41.2 and 53.1% had evidence of arthropathy or related disorders, and pain, respectively. Along with all-cause and hemophilia-related healthcare resource utilization (HCRU), these were highest among PwHA aged 56–89 years. Conclusion: Insights into treatment, outcomes and HCRU may identify opportunities for enhanced disease management, particularly in older PwHA.

scholarly journals P.113 A Population-based Study of the Epidemiology, Healthcare Resource Utilization and Costs of Duchenne Muscular Dystrophy in Alberta, Canada

2021 ◽  
Vol 48 (s3) ◽  
pp. S51-S51
Author(s):  
G Chen ◽  
B Sharif ◽  
MS Farris ◽  
T Cowling ◽  
C Cabalteja ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Treatment Strategies ◽  
Medical Costs ◽  
Population Based ◽  
Healthcare Resource Utilization ◽  
First Year ◽  
Diagnostic Code

Background: Duchenne muscular dystrophy (DMD) is a severe progressive neuromuscular disease. This study aimed to estimate the prevalence, healthcare resource utilization (HRU), and medical costs of DMD in Alberta. Methods: This retrospective study linked provincial healthcare administrative data to identify patients with DMD utilizing a modified diagnostic code algorithm, including males <30 years of age. Five-year (April 2012 to March 2017) prevalence estimates were calculated and all-cause direct HRU and costs were examined in the first-year post-diagnosis. Results: Overall, 111 patients (median age: 12.0 years (IQR 4.7-18.3)) with DMD were identified. The estimated five-year period prevalence was 35.72 (95% CI 31.88-39.91) per 100,000 persons. All-cause HRU in the first-year post-diagnosis included a mean (SD) of 0.48 (1.19) hospitalizations (length of stay: 9.37 days (36.47)), 3.96 (6.16) general practitioner visits, 28.52 (62.98) specialist visits, and 20.14 (16.49) ambulatory care visits. Mean (SD) all-cause direct costs were $18,868 ($29,206) CAD in the first-year post-diagnosis. Conclusions: Patients with DMD had multiple interactions with the healthcare system in the year following diagnosis, resulting in substantial direct medical costs. More effective treatment strategies are needed to improve health outcomes and reduce the burden of DMD.

scholarly journals Economic burden of patients with inoperable advanced breast cancer receiving early or late capecitabine or trastuzumab as second-line treatment: A population-based study

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Chieh-Yu Liu
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Resource Utilization ◽  
Economic Burden ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Incidence Rates ◽  
Advanced Breast ◽  
Research Database ◽  
Second Line

This study aimed to investigate the economic burden and healthcare resource utilization of receiving early or late capecitabine and trastuzumab as second-line anthracycline- or taxane-based treatments for inoperable advanced breast cancer (IABC). Data was retrieved from the National Health Insurance Research Database of Taiwan. The demographic characteristics, healthcare resource utilization, and economic burden of patients with IABC receiving capecitabine and trastuzumab for 0–3, 3–6, 6–9 and 9–12 months after anthracycline- or taxane-based treatments were analyzed. 1,629 women newly diagnosed with IABC were recruited. IABC incidence rates reduced from 9.75% in 2004 to 7.35% in 2006. However, the proportion of patients receiving capecitabine or trastuzumab after anthracycline- or taxane-based treatments increased. Inpatient admissions (times/year), length of hospital stay (days/year), and outpatient visits (visits/year) did not differ significantly for the 2004–2005, 2005–2006 and 2006–2007 cohorts of patients with IABC receiving capecitabine and trastuzumab at different time points. The 1-year healthcare cost and outpatient, inpatient, and total costs (USD/year) differed significantly for trastuzumab but not for capecitabine. The conclusion indicated that early or late capecitabine or trastuzumab administration after first-line anthracycline or taxane-based treatments did not exhibit a change in healthcare resource utilization. In addition, the 1-year healthcare costs did not differ significantly for patients with IABC receiving early or late capecitabine. However, patients with IABC receiving trastuzumab continue to face an economic burden.

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