US Oncology Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
KMK Consulting Inc , Morristown , NJ , USA.
J Med Econ. 2019 Oct;22(10):1055-1062. doi: 10.1080/13696998.2019.1643354. Epub 2019 Aug 4.
This study aimed to evaluate the healthcare resource utilization (HCRU) and costs for patients with severe aplastic anemia (SAA) using US claims data. This retrospective, observational database study analyzed claims data from the Truven MarketScan databases. SAA patients aged ≥2 years identified between 2014 and 2017 who were continuously enrolled for 6 months before their first SAA treatment or blood transfusion, with a ≥6-month follow-up, were included. Baseline demographics and comorbidities were evaluated. Monthly all-cause and SAA-related HCRU and direct costs in the follow-up period were analyzed and differences were presented for all patients and across age groups. With an average follow-up period of 21.5 months, 939 patients were included in the study. Monthly all-cause and SAA-related HCRU [mean (SD)] were 1.65 days (2.61 days) and 0.18 days (0.70 days) for length of stay, 0.18 (0.23) and 0.01 (0.04) for hospital admissions, 0.25 (0.30) and 0.02 (0.07) for ER visits, 2.24 (1.40) and 0.46 (0.99) for office visits, and 2.90 (2.64) and 0.55 (1.31) for outpatient visits, respectively. On average, SAA patients received 0.15 (0.57) blood transfusions per month. Mean monthly all-cause direct costs were $28,280 USD ($36,127) [US dollars, mean (SD)]. Direct costs related to admissions were $11,433 USD (SD $25,040), followed by $624 USD ($1,703) for ER visits, $528 USD ($694) for office visits, $7,615 USD ($13,273) for outpatient visits, and $5,998 USD ($11,461) for pharmacy expenses. Monthly SAA-related direct costs averaged $7,884 USD (SD $16,254); of these costs, $1,608 USD ($7,774) were from admissions, $47 USD ($257) from ER visits, $127 USD ($374) from office visits, $1,462 USD ($4,994) from outpatient visits, and $4,451 USD ($10,552) from pharmacy expenses. SAA is associated with high economic burden, with costs comparable to blood malignancies, implying that US health plans should consider appropriately managing SAA while constraining the total healthcare costs when making formulary decisions.
本研究旨在使用美国索赔数据评估严重再生障碍性贫血（SAA）患者的医疗资源利用（HCRU）和成本。这项回顾性、观察性数据库研究分析了 Truven MarketScan 数据库中的索赔数据。纳入 2014 年至 2017 年间年龄≥2 岁、首次 SAA 治疗或输血前连续入组 6 个月、随访≥6 个月的患者。评估了基线人口统计学和合并症。分析了随访期间的每月全因和 SAA 相关 HCRU 和直接成本，并在所有患者和不同年龄组之间呈现差异。在平均 21.5 个月的随访期间，共有 939 名患者纳入研究。每月全因和 SAA 相关 HCRU（平均值[标准差]）为住院天数 1.65 天（2.61 天）和 0.18 天（0.70 天），住院天数 0.18（0.23）和 0.01（0.04），急诊就诊 0.25（0.30）和 0.02（0.07），就诊 0.24（0.30）和 0.02（0.07），门诊就诊 0.29（2.64）和 0.55（1.31）。平均而言，SAA 患者每月接受 0.15（0.57）次输血。每月全因直接费用平均为 28,280 美元（36,127 美元）。与入院相关的直接费用为 11,433 美元（SD 25,040 美元），其次是急诊就诊 624 美元（1,703 美元），门诊就诊 528 美元（694 美元），门诊就诊 7,615 美元（13,273 美元），药房费用 5,998 美元（11,461 美元）。每月 SAA 相关的直接费用平均为 7,884 美元（SD 16,254 美元）；其中，1,608 美元（7,774 美元）来自住院，47 美元（257 美元）来自急诊就诊，127 美元（374 美元）来自门诊就诊，1,462 美元（4,994 美元）来自门诊就诊，4,451 美元（10,552 美元）来自药房费用。SAA 与高经济负担相关，其成本与血液恶性肿瘤相当，这意味着美国健康计划在制定处方决策时，应考虑适当管理 SAA，同时控制总医疗成本。
