scholarly journals Healthcare resource utilization and costs associated with anogenital warts in Morocco

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Myriam Berrada ◽  
Ryan Holl ◽  
Tidiane Ndao ◽  
Goran Benčina ◽  
Siham Dikhaye ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Public Hospitals ◽  
Medical Attention ◽  
Public Healthcare ◽  
Total Annual Cost ◽  
Delphi Panel ◽  
Anogenital Warts

Abstract Background Human papillomavirus (HPV), primarily genotypes 6 and 11, cause the majority of cases of anogenital warts (AGW). Although benign, AGW are associated with a substantial economic and psychosocial burden. Several vaccines have been developed to prevent HPV. The objective of this study was to describe the epidemiology and healthcare resource utilization of AGW in Morocco, as well as the associated costs of treatment from the public healthcare perspective. Methods This was a descriptive analysis of questionnaire data obtained via a Delphi panel. The panel consisted of 9 physicians practicing in public hospitals in Morocco (4 dermatologists and 5 obstetricians/gynecologists). The questionnaire collected data on physician and practice characteristics, diagnostic tests and procedures, treatments, and follow-up (including recurrence) of patients with AGW. Questionnaire items on which ≥ 70% of respondents agreed were considered as having consensus. Costs associated with diagnosis, treatment, and follow-up were calculated in Moroccan dirham (MAD) and converted to euros (€) based on official national price lists for public hospitals and the HCRU estimates from the questionnaire. Results The physician-estimated prevalence of AGW in Morocco was 1.6%-2.6% in women and 2.0%-5.3% in men. A mean (median) of 6.4 (4) patients per month per physician sought medical attention for AGW. Simple observation was the most common diagnostic method for AGW in both men and women, and excision was the most prescribed therapy (75%), requiring a mean of 2 visits. Recurrence occurred in approximately 27% of patients. The cost per case of managing AGW, including recurrence, was estimated at 2182–2872 MAD (€207–272) for women and 2170–2450 MAD (€206–233) for men. The total annual cost of medical consultations for AGW in Morocco ranged from 3,271,877 MAD to 4,253,703 MAD (€310,828–404,102). Conclusions Expert consensus indicates that AGW represent a significant burden to the Moroccan public healthcare system. These data can inform policy makers regarding this vaccine-preventable disease.

scholarly journals Analysis of Healthcare Resource Utilization and Costs after the Initiation of Biologic Treatment in Patients with Ulcerative Colitis and Crohn’s Disease

10.36469/9791 ◽  
2018 ◽  
Vol 6 (1) ◽  
pp. 96-112 ◽  
Author(s):  
Sue Perera ◽  
Shibing Yang ◽  
Marni Stott-Miller ◽  
Joanne Brady
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Small Sample ◽  
Outpatient Visits ◽  
Ed Visits

Background: This retrospective cohort study aimed to describe and quantify healthcare resource utilization and costs for patients with ulcerative colitis (UC) and Crohn’s disease (CD) following initiation of biologic therapy. Methods: Resource utilization and costs were analyzed at baseline and 1- and 2-years after initiating a biologic. Data were extracted from a US administrative health insurance claims database for adults ≥18 years. Eligible patients were continuously enrolled in a health plan with medical and pharmacy benefits for ≥12 months prior to, and 12 months (primary analysis) or 24 months (secondary analysis) after index date (biologic initiation). Results: In total, 4864 and 2692 patients with UC, and 8910 and 5227 patients with CD were identified in the 1- and 2-year follow-up cohorts, respectively. Of 1-year follow-up cohort patients, 45% received the same biologic initiated at index for ≥1 year. Infliximab and adalimumab were the most commonly initiated biologics in patients with UC or CD. The highest proportion of patients who continued with the same biologic after 1-and 2-years had initiated therapy with infliximab for both indications (although at the 1-year follow-up for CD, the highest proportion continued to use natalizumab, but this was a small sample [n=15]). Generally, the proportion of patients having inpatient admissions and emergency department (ED) visits decreased after receiving the same biologic for 1 year compared with baseline, although the proportion having outpatient visits did not change. Mean per patient all-cause costs for inpatient hospitalizations, ED visits and outpatient visits decreased for patients with UC or CD who received the same biologic for 1 year, while mean pharmacy costs per patient increased. Conclusions; This descriptive analysis shows that although biologics effectively reduced inpatient and ED resource utilization and corresponding costs in patients with UC and CD, total management costs increased, driven by increased pharmacy costs.

scholarly journals 2374. Healthcare Resource Use, Costs, and Recurrences in Patients with Clostridioides difficile Infection: A Real-world Data Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S819-S819
Author(s):  
Winnie Nelson ◽  
Laura Stong ◽  
Naomi Sacks ◽  
Alexandria Portelli ◽  
Bridget Healey ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Resource Use ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Healthcare Resource Use ◽  
Diagnosis Code ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Ed Visits

Abstract Background Clostridioides difficile infection (CDI), especially recurrent CDI (rCDI), is associated with high morbidity and resource use and imposes a significant burden on the US healthcare system. The objective of this study was to evaluate the burden of rCDI on healthcare resource utilization. Methods A retrospective study analyzed commercial claims data from patients aged 18–64 years old in the IQVIA PharMetrics Plus™ database. CDI episodes required an inpatient stay with CDI diagnosis code (ICD-9-CM 008.45; ICD-10-CM A04.7, A04.71, A04.72), or an outpatient medical claim with CDI diagnosis code plus a CDI treatment, and index episodes occurred from January 1, 2010 to June 30, 2017. Only patients who were observable 6 months before and 12 months after the index CDI episode were included. Each CDI episode was followed by a 14-day claim-free period after the end of treatment. rCDI was defined as another CDI episode within an 8-week window immediately after the claim-free period. Number of CDI and rCDI episodes, healthcare resource use, and costs were calculated over 12-month follow-up and stratified by number of rCDI episodes. Costs were adjusted to 2018 dollars. Results 46,571 patients with an index CDI episode were included, with 3,129 (6.7%) who had 1 rCDI, 472 (1.0%) who had 2 rCDI, and 134 (0.3%) who had 3+ rCDI episodes. Mean age was 47.4 years, and 62.4% were female. In the 12-month follow-up, the mean (SD) numbers of inpatient visits were 1.4 (2.1) for those with no rCDI, 2.7 (3.4) for those with 1 rCDI, 3.7 (3.9) for those with 2 rCDI, and 5.8 (6.0) for those with 3+ rCDI episodes. Emergency department (ED) visits had a similar trend, with mean (SD) number of visits of 1.5 (3.5), 2.5 (6.0), 3.7 (7.0), and 4.6 (13), respectively for the four study groups. All-cause costs after the index CDI were $71,980 for those with no rCDI, $131,953 for those with 1 rCDI, $180,574 for those with 2 rCDI, and $207,733 for those with 3+ rCDI. Conclusion CDI and rCDI are associated with substantial healthcare resource utilization and direct medical costs. During the 12 months after an index CDI episode, the number of inpatient admissions and ED visits increased substantially for patients with an rCDI episode. Direct medical costs for patients with rCDI also increased with number of recurrences. Disclosures All authors: No reported disclosures.

Healthcare Resource Utilization Trends over Time with Continuous Lenalidomide Treatment (Tx) in Patients (Pts) with Newly Diagnosed Multiple Myeloma (NDMM)

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1326-1326
Author(s):  
Katja Weisel ◽  
Dan T. Vogl ◽  
Michel Delforge ◽  
Kevin Song ◽  
Meletios Dimopoulos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Resource Utilization ◽  
Research Funding ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Medical Utilization ◽  
Fixed Duration ◽  
Advisory Committees ◽  
Over Time

Abstract Introduction: Multiple myeloma (MM) is an incurable hematologic condition that is associated with high Tx costs. Resource consumption is driven by hospitalization and medical utilization, which is highest during periods of uncontrolled disease, such as after diagnosis and during relapses (De Portu 2013). In the pivotal phase 3 FIRST trial, continuous Tx with lenalidomide plus low-dose dexamethasone (Rd) was compared with fixed-duration Rd (Rd18) or fixed-duration combination Tx with melphalan, prednisone, and thalidomide (MPT), each for 18 months (mos), in NDMM pts who were ineligible for stem cell transplantation. Continuous Rd extended progression-free survival (PFS) and overall survival (interim analysis) vs. MPT. However, it is still unclear whether extending Tx duration with Rd adversely affects healthcare resource utilization. This analysis quantifies the rates of hospitalizations and medical utilization with continuous Rd over time based on data collected in the FIRST trial. Methods: The FIRST trial (N = 1,623) was a pivotal multinational, randomized, open-label study with a median follow up of 37 mos. Non-protocol-driven resource-use data was collected until subjects discontinued study Tx. To assess whether continuous Rd increases healthcare resource utilization over time, the rates of resource utilization for subjects treated with continuous Rd (N = 535) were plotted for up to 48 mos. In addition, hospitalization and medical utilization rates during the Tx period (18 mos) were estimated and compared between the 2 fixed-duration Tx arms. Results: Resource utilization amongst pts treated with continuous Rd declined over time (Figure). The annualized hospitalization rate in the first 3 mos was 3.2 times higher than the average rate for the remaining 45 mos of follow-up (2.02 vs. 0.62), and 4.2 times higher for medical utilization (5.66 vs. 1.34). After 4 years (yrs) of continuous Rd Tx, hospitalization and medical utilization rates were estimated to be 83% and 84% lower than those observed in the first 3 mos of Tx, reflecting the long-term disease control observed with continuous Rd in the FIRST trial. The highest hospitalization rates were associated with infections (0.20 per patient year), cardiovascular disorders (0.06), and respiratory and thoracic disorders (0.05). The mean (standard deviation) length of stay per admission was 14.08 (21.19) days. The highest medical utilization rates were associated with blood transfusions (0.76 interventions per patient year), general imaging procedures (0.21), respiratory and thoracic imaging procedures (0.20), and therapeutic interventions (0.09).The hospitalization rates for the fixed dose Tx arms were 0.91 (Rd18) and 0.79 (MPT) per patient year of follow-up during the Tx period of 18 mos, resulting in a rate ratio (RR) of 1.15 (1.01–1.30). The equivalent rates for medical utilization were 3.00 (Rd18) and 2.86 (MPT) medical interventions per patient year (RR = 1.05 [0.98–1.12]). Conclusions: The rates of resource utilization among pts treated with continuous Rd dropped substantially after the first 3 mos of Tx, and then gradually declined as Tx duration increased. The findings suggest that continuous Tx with Rd does not further increase resource utilization in hospitalizations and medical utilization compared to fixed-duration Tx. A comparison between the 2 fixed arms showed a 15% increase in hospitalization with Rd18 vs. MPT, and no differences in medical utilization between the 2 arms. A limitation of this analysis is that the resources were collected only while pts were receiving their respective Txs. Future analysis should include all costs generated by healthcare resources throughout pts Tx, including Tx-free intervals, and the costs associated with relapses. Figure 1: Hospitalization and medical utilization rates per patient year for patients treated with continuous Rd Figure 1:. Hospitalization and medical utilization rates per patient year for patients treated with continuous Rd Disclosures Weisel: BMS: Consultancy; Onyx: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Celgene Corporation: Consultancy, Honoraria; Noxxon: Consultancy. Off Label Use: Lenalidomide used in newly diagnosed multiple myeloma patients. Vogl:Amgen: Consultancy; Millennium/Takeda: Research Funding; GSK: Research Funding; Acetylon: Research Funding; Celgene Corporation: Consultancy. Delforge:Janssen: Honoraria; Celgene Corporation: Honoraria. Song:Celgene Corporation: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Dimopoulos:Celgene Corporation: Consultancy, Honoraria. Cavenagh:Celgene Corporation: Honoraria. Hulin:Celgene Corporation: Honoraria. Foá:Celgene Corporation: Consultancy. Oriol:Janssen: Consultancy, Speakers Bureau; Celgene Corporation: Consultancy, Speakers Bureau. Guo:Celgene Corporation: Consultancy. Monzini:Celgene Corporation: Employment, Equity Ownership. Van Oostendorp:Celgene: Employment. Ervin-Haynes:Celgene: Employment. Facon:Celgene Corporation: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

Healthcare Resource Utilization By Treatment Response Level in Patients with Relapsed Multiple Myeloma: Results of a Delphi Panel Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5608-5608
Author(s):  
Michele Thomas ◽  
Yaozhu J Chen ◽  
Ken Bridges ◽  
Maria Lankford ◽  
Ze Cong ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Treatment Response ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Delphi Panel ◽  
Response Level ◽  
Bone Marrow Biopsies ◽  
Pet Scans

Abstract Background With the advancements in relapsed multiple myeloma (RMM) treatments and healthcare resource constraints, it is important to understand the impact of response to RMM treatments on healthcare resource utilization (HRU). We conducted a consensus study in the United States to investigate how HRU may vary by RMM treatment response level. Methods A two-round Delphi panel was formed to generate consensus-based estimates of HRU in RMM patients (pts). Ten US hematologists or oncologists meeting the selection criteria (i.e., treated ≥6 RMM pts in the past year; see ≥1 newly diagnosed multiple myeloma pts monthly; spend ≥75% of time in direct pt care) were recruited. All panelists remained anonymous during the process. In Round 1, each clinician was presented with 16 RMM pt types that varied in age (<65, 65+), ECOG performance status (0-1, 2+), and modified International Myeloma Working Group response levels (complete response [CR], partial response [PR], stable disease [SD], and progressive disease [PD]). For each pt type presented, physicians were asked to provide annual HRU estimates (in open-ended format) for 11 service categories as informed by pilot telephone interviews with clinicians (e.g., physical exams [PE], emergency room [ER] visits with and without a hospitalization, transfusions, and bone marrow biopsies). Round 2 focused on categories likely to have a more significant impact on RMM care: PE; ER visits with or without a resulting admission; bone marrow biopsies; supportive prescription medications; transfusions; and PET scans. In this structured survey, a summary of the annual HRU estimates for each pt type and service category from Round 1 was presented. Panelists reviewed blinded, individual estimates obtained in Round 1 and were asked to revisit their own estimates, if appropriate. Consensus was defined as a priori when ≥75% agreement on categorical items and ≤20% between interquartile range (25th and 75th percentiles) for continuous items. Near consensus was reached when there was 60% to 74% agreement. Results Overall, physicians emphasized the variability of HRU based on pt characteristics and response level. Full consensus was rare, and most often cited in CR. Near consensus was more common, typically in a specific pt type, not by response level (Table 1). However, some generalities can be noted: For the most costly resources, CR pts are projected to have fewer ER visits (range: 0-1) than non-CR pts irrespective of hospitalization (ER visit with admission: PR 0-2, SD 1, PD 1-2; ER visit, no admission: PR, SD and PD 1-2). Bone marrow biopsy use will likely be higher in non-CR pts (0-1 for PR and SD, 1 in PD vs 0 for CR pts). Non-CR pts are expected to need more PEs (range: 6-17) a year than CR pts (mode: 6). Erythropoietin stimulating agents (ESAs) are unlikely for non-PD pts. Similarly, transfusions are only projected for PD pts. Consistent with NCCN guidelines, bisphosphonates will be ordered for all pts across response levels. However, antibiotics and G-CSF are likely unnecessary in pts at any response level. The need for PET scans and bone scans/surveys/X-rays could not be adequately determined. Conclusions This study demonstrates that CR may be associated with a lower level of resource use in pts with RMM. The importance of novel treatment options for RMM that control the disease more effectively might yield the cost offsets associated with deeper response in those options. Disclosures Thomas: Xcenda: Employment. Chen:Onyx Pharmaceuticals: Employment. Bridges:Amgen Inc: Employment. Lankford:Xcenda: Employment. Cong:Onyx Pharmaceuticals: Employment, Equity Ownership. Lee:Xcenda: Employment.

O2-11-04: Effect of Dementia Care Management on Healthcare Resource Utilization and Cost: One-year follow-Up Results of the Delphi Trial

2016 ◽  
Vol 12 ◽  
pp. P255-P255 ◽  
Author(s):  
Bernhard Michalowsky ◽  
Jochen René Thyrian ◽  
Diana Wucherer ◽  
Tilly Eichler ◽  
Johannes Hertel ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Care Management ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Dementia Care ◽  
One Year

scholarly journals Comparative Effectiveness, Safety, and Costs of Rivaroxaban and Warfarin Treatment Among Morbidly Obese Patients with Venous Thromboembolism

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2537-2537 ◽  
Author(s):  
Alex C. Spyropoulos ◽  
Veronica Ashton ◽  
Yen-Wen Chen ◽  
Bingcao Wu ◽  
Eric D. Peterson
Keyword(s):  
Resource Utilization ◽  
Major Bleeding ◽  
Healthcare Resource ◽  
Statistical Significance ◽  
Healthcare Resource Utilization ◽  
Morbidly Obese ◽  
Warfarin Treatment ◽  
Inpatient Hospitalizations ◽  
Recurrent Vte

Abstract Background: Use of direct-acting oral anticoagulants (DOACs) in morbidly obese (BMI >40 kg/m2) patients for venous thromboembolism (VTE) treatment is not fully understood. Current International Society of Thrombosis and Haemostasis guidelines do not recommend DOAC use in morbidly obese patients due to limited clinical data in this patient population. Objective: Compare risk of recurrent VTE, major bleeding, healthcare resource utilization, and costs between morbidly obese VTE patients initiating rivaroxaban or warfarin treatment. Methods: This is a retrospective 1:1 propensity score matched cohort study. VTE patients initiating rivaroxaban or warfarin were identified from Truven MarketScan Commercial Claims and Encounters and Medicare Supplemental database (12/1/2011-12/31/2016). An ICD-9/ICD-10 diagnosis code for morbid obesity was required during the 12 months pre- or 3 months post-initiation. Patients were followed ≥3 months. Analyses were conducted during the entire follow-up period regardless of discontinuation as well as on-treatment prior to discontinuation of index treatment. Major bleeding was assessed using the validated claims-based algorithm developed by Cunningham et al. 2011. Conditional logistic regression and generalized linear models were used to compare recurrent VTE and major bleeding risks, all-cause healthcare resource utilization, and per patient per year (PPPY) costs. Results: Among 5,780 rivaroxaban or warfarin treated patients (2,890 in each matched cohort), mean age was 53 ±13 years; 60% were female; mean follow-up time was 10.0 months and 10.5 months, respectively. Mean time between VTE diagnosis and treatment start was 14 days. Risk of recurrent VTE was similar for both cohorts in the intent-to-treat analysis (OR: 0.99, 95% CI: 0.85-1.14, p=0.844). Major bleeding risk was numerically lower for the rivaroxaban cohort but did not reach statistical significance in the on-treatment analysis (OR: 0.75, 95% CI: 0.47-1.19, p=0.227). Rivaroxaban treated patients utilized fewer all-cause healthcare resources, specifically inpatient hospitalizations (OR: 0.86, 95% CI: 0.77-0.96, p=0.006) and outpatient visits (OR: 0.23, 95% CI: 0.10-0.56, p=0.001) compared to warfarin (Table). Rivaroxaban patients incurred an average $2,829 lower total medical costs PPPY, ($34,824 vs $37,653, p=0.020), mainly driven by hospitalization costs. Total healthcare costs (including pharmacy) showed a numerical $1,531 reduction for rivaroxaban patients, not reaching statistical significance ($43,034 vs. $44,565, p=0.237). Conclusions: Our study showed that morbidly obese VTE patients treated with rivaroxaban had similar risk of recurrent VTE and major bleeding compared to warfarin. Treatment with rivaroxaban yielded less all-cause healthcare resource utilization (i.e. inpatient hospitalizations and outpatient visits) and reduced total medical costs. Disclosures Spyropoulos: Janssen Scientific Affairs, LLC: Consultancy. Ashton:Janssen Scientific Affairs, LLC: Employment. Chen:Janssen Scientific Affairs, LLC: Employment. Wu:Janssen Scientific Affairs, LLC: Employment. Peterson:Janssen Scientific Affairs, LLC: Consultancy.

scholarly journals Real-World Healthcare Resource Utilization in Patients with Indolent Non-Hodgkin's Lymphoma: Differences between Patients Treated First-Line with Ibrutinib or Bendamustine + Rituximab

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3549-3549
Author(s):  
Debra Irwin ◽  
Lu Zhang ◽  
Kathleen Wilson ◽  
Gerard Hoehn ◽  
Erika Szabo ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Healthcare Utilization ◽  
Resource Utilization ◽  
Real World ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Hodgkin's Lymphoma ◽  
First Line

Abstract OBJECTIVES: The purpose of this study was to examine real-world differences in healthcare resource utilization of indolent non-Hodgkin's Lymphoma (iNHL) patients treated with first-line ibrutinib monotherapy (IM) or first-line bendamustine + rituximab (BR) combination therapy using U.S. administrative claims data. METHODS: The MarketScan® Research Databases were used to identify patients aged 18 years or older with commercial or Medicare supplemental insurance plans based on their first prescription (index date) of either IM or BR therapy between 02/01/2014 and 08/30/2017. Patients were required to be diagnosed with iNHL and be treatment naïve, as well as be continuously enrolled (CE) for 6 months prior to and at least 30 days following the index date. All-cause and iNHL-related healthcare resource utilization (e.g., inpatient admission (IP) and emergency room (ER) visits) were evaluated during a 12-month follow-up period from the index date among the subset of patients with 12 months of continuous enrollment and reported per-patient per-month (PPPM). Statistical differences in the distribution of IP and ER visits between the IM versus BR therapy groups were estimated using chi-squared test for categorical variables and t-test for continuous variables. RESULTS: A total of 1,544 iNHL patients were identified, with 207 patients in the IM cohort and 1,337 patients in the BR cohort. The IM cohort was significantly older (mean = 68.3 years; SD = 11.8) then the BR cohort (mean age = 62.1 years; SD = 11.1). The proportion of females was significantly (p<.05) lower in the IM cohort (36%) relative to the BR cohort (49%). The two cohorts did not differ in comorbidity as assessed by National Cancer Institute Comorbidity Index score (IM=0.7 vs. BR=0.8, p=0.40). The results of the comparisons between the two groups with 12 months of follow-up (IM = 110; BR = 745) are provided in Table 1. For all-cause healthcare utilization, the proportion of IM patients experiencing at least one IP admission was significantly higher than the BR cohort as were the PPPM number of admissions. The proportion of patients with at least one ER visit was similar in the IM and BR cohorts. However, the average PPPM number of ER visits was significantly higher in the IM cohort relative to the BR cohort. A similar pattern was found for the iNHL-related healthcare utilization variables with one exception. The proportion of patients with at least one iNHL-related ER visit was significantly higher in the IM relative to the BR cohort. Conclusions: The current study examined differences in healthcare utilization among iNHL-patients treated in a front-line setting with either ibrutinib or BR combination therapy. Results indicated that not only did more ibrutinib patients experience an IP admission and ER visits, including both all-cause and iNHL-related, but they also experienced more repeat admissions and ER visits. These real-world findings highlight the importance of considering the healthcare resource utilization of iNHL patients which may be associated with their first-line therapy. Disclosures Irwin: Teva: Consultancy. Zhang:Teva: Consultancy. Wilson:Teva: Consultancy. Hoehn:Teva: Employment. Szabo:Teva: Employment. Tang:Teva: Employment.

Healthcare Resource Utilization and Costs Associated with Venous Thromboembolism Recurrence in Patients with Cancer

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4734-4734
Author(s):  
Alok A. Khorana ◽  
Keith R. McCrae ◽  
Dejan Milentijevic ◽  
Jonathan Fortier ◽  
François Laliberté ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Resource Utilization ◽  
Healthcare Costs ◽  
Research Funding ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Patients With Cancer ◽  
Equity Ownership ◽  
Recurrent Vte

Abstract Introduction: Patients with cancer are not only at a high risk for developing primary but also recurrent venous thromboembolism (VTE). These events lead to increased burden of cancer management and healthcare costs. It was estimated that all-cause health care costs for cancer patients with VTE were $30,538/patient higher than in those without VTE (Khorana, 2013). To our knowledge, very little information exists on cost of VTE recurrence among cancer patients. The objective of this study was to analyze resource utilization and costs of patients with cancer experiencing a VTE recurrence using a large claims database. Methods: Medical and pharmacy claims from the Humana Database between 1/1/2013 and 05/31/2015 were analyzed. Newly diagnosed cancer patients with a first VTE diagnosis occurring after their first cancer diagnosis and with ≥1 dispensing of an anticoagulant agent within 7 days after their VTE diagnosis, were selected. Baseline characteristics were evaluated during the 6 month period prior to the index VTE. VTE recurrences were defined as hospitalizations with a primary diagnosis of VTE. Patients were classified into two groups: patients who experienced a VTE recurrence and patients who did not. Resource utilization and costs were evaluated for the entire follow up period, starting with the initiation of the anticoagulant therapy until whichever was earlier, end of eligibility or end of data. Healthcare resource utilization evaluated included number of hospitalizations, hospitalization days, emergency room (ER) visits, and outpatient visits. All-cause and VTE-related healthcare resource utilization was evaluated. Comparisons between patients with a VTE recurrence and patients without a VTE recurrence were performed using rate ratios (RR) and statistical differences between groups as well as 95% confidence intervals [95% CI] were calculated using Poisson regression models. All-cause and VTE-related healthcare costs were evaluated in per-patient-per-year (PPPY) and compared using mean cost difference. Results: A total of 2,428 newly diagnosed cancer patients who developed VTE and were treated with anticoagulants were identified. Of these, 413 (17.1%) experienced recurrent VTE during the follow up period. Patients who developed recurrent VTE and those who did not were similar in terms of age, gender, race, and region. No statistically significant differences between groups were observed in Charlson comorbidity index or in selected comorbidities during the 6 month baseline period. However, more patients with recurrent VTE recurrence had their index VTE documented during a hospitalization (61.3% vs. 55.4%, p=0.03). Patients with a VTE recurrence had significantly more ER and outpatient visits at baseline compared to those without recurrence, but no statistically significant difference was observed in baseline total healthcare costs ($29,352 vs. $27,955, p=0.44, respectively). The mean follow-up was similar between groups: 9.6 months for patients experiencing a VTE recurrence and 9.3 months for patients without a VTE recurrence (p=0.4059). Patients with a VTE recurrence had higher all-cause resource utilization rates (RRs; 95% CI) compared to patients without a VTE recurrence (hospitalization [2.37; 2.23 - 2.52], hospitalization days [2.64; 2.57 - 2.72], ER visits [1.62; 1.48 - 1.76], and outpatient visits [1.26; 1.24 - 1.28]). The rates of VTE-related hospitalization and VTE-related hospitalization days were close to $30,000 higher in patients with a VTE recurrence (Figure 1). The all-cause healthcare costs were $84,708 PPPY in patients with a VTE recurrence compared to $44,903 in patients without a VTE recurrence. The difference was mainly explained by lower VTE-related hospitalization costs (Figure 2). Conclusion: This real-world claims analysis showed that cancer patients with recurrent VTE consume significantly more healthcare resources. Total healthcare costs were nearly 2-fold higher in cohort with than in cohort without VTE recurrence. Close to 75% of the total cost difference was associated with VTE recurrence. VTE-related costs were ~4-fold higher in cohort with than in cohort without VTE recurrence. Reducing VTE recurrence in patients with cancer could lead to substantial healthcare cost savings. Figure 1 VTE-Related Healthcare Resource Utilization Figure 1. VTE-Related Healthcare Resource Utilization Figure 2 VTE-Related Healthcare Costs, PPPY Figure 2. VTE-Related Healthcare Costs, PPPY Disclosures Khorana: Pfizer: Consultancy, Honoraria; Bayer: Consultancy, Honoraria; Sanofi: Consultancy, Honoraria; Halozyme: Consultancy, Honoraria; Amgen: Consultancy, Honoraria, Research Funding; Janssen Scientific Affairs, LLC: Consultancy, Honoraria, Research Funding; Leo: Consultancy, Honoraria, Research Funding; Roche: Consultancy, Honoraria. McCrae:Janssen: Membership on an entity's Board of Directors or advisory committees. Milentijevic:Janssen Scientific Affairs: Employment, Equity Ownership. Fortier:Janssen Pharmaceuticals: Research Funding. Laliberté:Janssen Scientific Affairs: Research Funding. Crivera:Janssen Scientific Affairs, LLC, Raritan, New Jersey: Employment, Equity Ownership. Lefebvre:Janssen Scientific Affairs: Research Funding. Schein:Johnson & Johnson: Employment, Equity Ownership, Other: Own in excess of $10,000 of J&J stock.

PP79 Impact Of Hidradenitis Suppurativa On Healthcare Resource Utilization

2019 ◽  
Vol 35 (S1) ◽  
pp. 52-52
Author(s):  
Larissa de Araujo Costa Andrade ◽  
Ricardo Moreira ◽  
Vinicius Vitale
Keyword(s):  
Health Services ◽  
Resource Utilization ◽  
Inpatient Care ◽  
Hidradenitis Suppurativa ◽  
Healthcare Resource ◽  
Unit Cost ◽  
Healthcare Resource Utilization ◽  
Public Healthcare ◽  
Strong Impact ◽  
Total Cost

IntroductionHidradenitis suppurativa (HS) is a debilitating, chronic inflammatory skin disease characterized by painful nodules and abscesses. HS has a strong impact on patient quality of life. In Brazil, the prevalence of HS is estimated at 0.4 percent. Medical and surgical treatments have low effectiveness and disease recurrence is common, which affects health system costs. This study aimed to assess how HS patients utilize medical care (emergency and inpatient care) in Brazil and to describe the all-cause costs.MethodsData were retrieved from a public healthcare claims database (DATASUS), which provides access to information regarding health services and costs. Data from DATASUS were used to perform a cost-identification analysis on patients with HS who used health services over a two-year period. A retrospective bottom-up approach was used to estimate direct costs, multiplying the amount of each medical resource consumed by its unit cost.ResultsOver the two-year period, 90 patients (16%) with HS received inpatient care (151 procedures) at a total cost of BRL 83,520 (USD 21,715). Surgeries were the most frequently performed (73% of total) and expensive procedures, costing BRL 73,122 (USD 19,011; 88% of total costs), followed by clinical treatments (BRL 8,354 [USD 2,172]; 10%), and physician consulting (BRL 1,659 [USD 431]; 2%). For the 500 patients treated in the emergency department (total cost BRL 3,027 [USD 787]), the most frequently received services were physician consulting (34%), nursing care (12%), and minor surgeries (11%). Each patient received, on average, three procedures over the two-year period.ConclusionsHS is a high-burden disease, as demonstrated by the high healthcare resource utilization among patients. Since DATASUS is a public database, the costs presented reflect a government reference price and do not consider local costs, which is a limitation of this study. Health managers should be aware of this finding, although further research is needed to investigate the effect of healthcare utilization on patient outcomes.

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