Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA.
J Ophthalmic Inflamm Infect
; 3(1): 64, 2013 Nov 06.
Article
em En
| MEDLINE
| ID: mdl-24195808
ABSTRACT
BACKGROUND:
The purpose of this study was to describe comorbidities, healthcare costs, and resource utilization among patients with chronic non-infectious uveitis initiating corticosteroid, immunosuppressants, or biologics.In this retrospective cohort study, patients with a non-infectious uveitis diagnosis and continuous insurance coverage during a 6-month baseline were selected from a privately insured claims database with 80.7 million enrollees. Index dates were defined as the first prescription/administration of a corticosteroid, immunosuppressant, or biologic between 2003 and 2009. Comorbidities, healthcare costs, and utilization were analyzed in a per-member-per-month (PMPM) framework to account for varying between-patient treatment periods, defined as continuous medication use within the same class. Wilcoxon rank-sum and chi-square tests were used for comparisons of costs and categorical outcomes.RESULTS:
Patients on corticosteroids (N = 4,568), immunosuppressants (N = 5,466), and biologics (N = 1,694) formed the study population. Baseline PMPM inpatient admission rates were 0.029 for patients on corticosteroids, 0.044 for patients on immunosuppressants, and 0.045 for patients on biologics (p < 0.001 immunosuppressants or biologics versus corticosteroids); during treatment, PMPM inpatient admissions increased to 0.044 and 0.048 for patients taking corticosteroids and immunosuppressants, respectively, but decreased to 0.024 for patients taking biologics (p < 0.001 versus corticosteroids and p = 0.003 versus immunosuppressants). Baseline average PMPM costs for patients taking corticosteroids, immunosuppressants, and biologics were US$935, US$1,738, and US$1,439 (p < 0.001 between groups), while on-treatment PMPM costs excluding drug costs increased to US$1,129 for patients taking corticosteroids but lowered to US$1,592 for patients taking immunosuppressants, and US$918 for patients taking biologics (p < 0.001 versus corticosteroids or immunosuppressants).CONCLUSIONS:
There is significant economic burden associated with existing treatments of uveitis. Corticosteroids may be overused as a treatment for uveitis.
Texto completo:
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Temas:
ECOS
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Financiamentos_gastos
Bases de dados:
MEDLINE
Tipo de estudo:
Health_economic_evaluation
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Observational_studies
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Risk_factors_studies
Aspecto:
Implementation_research
Idioma:
En
Revista:
J Ophthalmic Inflamm Infect
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos