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美国特应性皮炎负担:商业、医疗保险和医疗救助数据库中的医疗保健理赔数据分析

Burden of Atopic Dermatitis in the United States: Analysis of Healthcare Claims Data in the Commercial, Medicare, and Medi-Cal Databases.

作者信息

Shrestha Sulena, Miao Raymond, Wang Li, Chao Jingdong, Yuce Huseyin, Wei Wenhui

机构信息

STATinMED Research/SIMR, Inc., Plano, TX, USA.

Sanofi US, Bridgewater, NJ, USA.

出版信息

Adv Ther. 2017 Aug;34(8):1989-2006. doi: 10.1007/s12325-017-0582-z. Epub 2017 Jul 13.

Abstract

INTRODUCTION

Comparative data on the burden of atopic dermatitis (AD) in adults relative to the general population are limited. We performed a large-scale evaluation of the burden of disease among US adults with AD relative to matched non-AD controls, encompassing comorbidities, healthcare resource utilization (HCRU), and costs, using healthcare claims data. The impact of AD disease severity on these outcomes was also evaluated.

METHODS

Adult AD patients in the Commercial (n = 83,106), Medicare (n = 31,060), and Medi-Cal (n = 5550) databases were matched (1:1) to non-AD controls by demographic characteristics. AD patients were stratified by disease severity (higher, lower) using treatment as a surrogate measure of severity. The comorbidity burden, HCRU, and costs were evaluated during a 12-month follow-up period.

RESULTS

In the Commercial, Medicare, and Medi-Cal populations, patients with AD had a significantly higher overall comorbidity burden (P < 0.0001), an increased risk of asthma and allergic rhinitis (both P < 0.0001), higher HCRU (P < 0.05), and higher mean total per patient costs (Commercial: US$10,461 versus US$7187; Medicare: US$16,914 versus US$13,714; Medi-Cal; US$19,462 versus US$10,408; all P < 0.0001), compared with matched non-AD controls. Higher disease severity was associated with an increased comorbidity burden (P < 0.0001), HCRU (P < 0.05), and total costs (Commercial: US$14,580 versus US$7192; Medicare: US$21,779 versus US$12,490; Medi-Cal; US$22,123 versus US$16,639; all P < 0.0001) relative to lower severity disease.

CONCLUSION

In this large-scale, healthcare claims database analysis, AD patients had a significantly higher comorbidity burden, HCRU, and costs compared with matched non-AD controls. Higher disease severity was associated with an even greater comorbidity and economic burden.

FUNDING

Sanofi and Regeneron Pharmaceuticals, Inc.

摘要

引言

关于成人特应性皮炎(AD)相对于普通人群疾病负担的比较数据有限。我们利用医疗保健理赔数据,对美国成年AD患者相对于匹配的非AD对照人群的疾病负担进行了大规模评估,包括合并症、医疗资源利用(HCRU)和成本。还评估了AD疾病严重程度对这些结果的影响。

方法

将商业数据库(n = 83,106)、医疗保险数据库(n = 31,060)和医疗救助数据库(n = 5550)中的成年AD患者按人口统计学特征与非AD对照进行1:1匹配。AD患者根据疾病严重程度(高、低)分层,将治疗作为严重程度的替代指标。在12个月的随访期内评估合并症负担、HCRU和成本。

结果

在商业、医疗保险和医疗救助人群中,与匹配的非AD对照相比,AD患者的总体合并症负担显著更高(P < 0.0001),哮喘和过敏性鼻炎风险增加(均P < 0.0001),HCRU更高(P < 0.05),平均每位患者的总费用更高(商业保险:10,461美元对7187美元;医疗保险:16,914美元对13,714美元;医疗救助:19,462美元对10,408美元;均P < 0.0001)。与疾病严重程度较低的患者相比,较高的疾病严重程度与合并症负担增加(P < 0.0001)、HCRU增加(P < 0.05)和总成本增加相关(商业保险:14,580美元对7192美元;医疗保险:21,779美元对12,490美元;医疗救助:22,123美元对16,639美元;均P < 0.0001)。

结论

在这项大规模的医疗保健理赔数据库分析中,与匹配的非AD对照相比,AD患者的合并症负担、HCRU和成本显著更高。更高的疾病严重程度与更大的合并症和经济负担相关。

资助

赛诺菲和再生元制药公司

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