Medical and Scientific Services, Real World Evidence Solutions, IQVIA, Falls Church, VA, USA.
Clinical Development and Medical Affairs, Nabriva Therapeutics US, Inc, King of Prussia, PA, USA.
Curr Med Res Opin. 2020 Jan;36(1):151-160. doi: 10.1080/03007995.2019.1675149. Epub 2019 Oct 17.
To assess the 1-year economic burden among patients hospitalized for community-acquired pneumonia (CAP) in the US. Adult patients hospitalized for CAP between 1/2012 and 12/2016 were identified from the IQVIA hospital charge data master (CDM) linked to the IQVIA Real-World Data Adjudicated Claims - US Database (date of admission = index date). Patients had continuous enrollment 180-days pre- and 360-days post-index, and empiric antimicrobial treatment (monotherapy [EM] or combination therapy [EC]) and chest x-ray on the index date or day after. All-cause and CAP-related healthcare resource utilization and cost were assessed over the 1-year follow-up. Generalized linear models (GLM) examined adjusted total cost. The cohort comprised 1624 patients hospitalized for CAP (mean age 50.3; 52.8% female). The majority (78.2%) initiated EC, most frequently with beta-lactams + macrolides (30.4%). The index hospitalization was associated with a mean length of stay (LOS) of 5.7 days and mean cost of $17,736; 22.7% had a transfer to the intensive care unit (ICU). All-cause readmission rates at 30- and 180-days were 8.8% and 20.1%, respectively. Mean annual all-cause total cost was $61,928; one-third (33.8%, $20,954) was related to CAP. The primary cost driver was inpatient care, which accounted for more than half (56.0%) of total all-cause cost and 94.3% of total CAP-related cost. Mean total inpatient cost was significantly higher among EC versus EM patients ($37,106 versus $25,999, = .0399). Adjusted mean total all-cause cost was $55,391. Patients hospitalized for CAP incurred a significant annual economic burden, driven substantially by the high cost of hospitalizations.
评估美国社区获得性肺炎(CAP)住院患者的 1 年经济负担。从 IQVIA 医院收费数据主文件(CDM)中确定了 2012 年 1 月至 2016 年 12 月期间因 CAP 住院的成年患者,该文件与 IQVIA 真实世界数据裁定索赔-美国数据库(入院日期=索引日期)相关联。患者在索引日期或索引日期后一天之前和之后 180 天有连续入组,并且在索引日期有经验性抗菌治疗(单药治疗[EM]或联合治疗[EC])和胸部 X 线检查。在 1 年的随访中评估了全因和 CAP 相关的医疗资源利用和成本。广义线性模型(GLM)检查了调整后的总费用。该队列包括 1624 名因 CAP 住院的患者(平均年龄 50.3;52.8%为女性)。大多数患者(78.2%)开始接受 EC,最常见的是使用β-内酰胺类药物+大环内酯类药物(30.4%)。索引住院与平均住院时间(LOS)为 5.7 天和平均费用 17736 美元相关;22.7%的患者转至重症监护病房(ICU)。30 天和 180 天的全因再入院率分别为 8.8%和 20.1%。平均年全因总费用为 61928 美元;三分之一(33.8%,20954 美元)与 CAP 相关。主要成本驱动因素是住院治疗,占全因总费用的一半以上(56.0%)和全因 CAP 相关费用的 94.3%。EC 患者的住院总费用明显高于 EM 患者(37106 美元比 25999 美元,P=0.0399)。调整后的平均全因总成本为 55391 美元。因 CAP 住院的患者每年都会产生巨大的经济负担,主要由住院费用高所致。