Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA

被引：32
作者：
Chu D.S. [1 ,2 ]
Johnson S.J. [3 ]
Mallya U.G. [4 ]
Davis M.R. [3 ]
Sorg R.A. [3 ]
Duh M.S. [3 ]
机构：
[1] Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, NJ 07960, 90 Bergen Street
[2] Metropolitan Eye Research and Surgery Institute, Palisades Park, NJ
[3] Analysis Group, Inc, Boston, MA 02199
[4] Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936
来源：
Journal of Ophthalmic Inflammation and Infection | / 3卷 / 1期
关键词：
Comorbidities; Healthcare costs; Healthcare utilization; Uveitis;
D O I：
10.1186/1869-5760-3-64
中图分类号：
学科分类号：
摘要：
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. © 2013 Chu et al.
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页码：1 / 10
页数：9
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