Barrow Neurological Institute, Phoenix, Arizona.
Ipsen, Cambridge, Massachusetts.
Endocr Pract. 2021 Oct;27(10):1034-1039. doi: 10.1016/j.eprac.2021.04.412. Epub 2021 May 1.
Acromegaly is associated with increased morbidity and mortality. Limited data are available on these patients' utilization and costs of health care. This study assessed the impact of acromegaly on employees' health benefit (direct and indirect) costs and absenteeism.
A retrospective analysis was conducted of drug and medical claims and employer data (from January 2010 to April 2019) of patients with an acromegaly diagnosis and matched controls from a U.S. employee database. Patient claims were tracked for 12 months postdiagnosis (or matched) date. Outcomes were analyzed using separate 2-part regression models, controlling for clinical, demographic, and job-related variables.
Forty-seven patients with acromegaly and 940 controls were identified. Cohorts were similar in most demographic and job-related variables. Patients with acromegaly had a significantly higher Charlson comorbidity index score and higher incidence of claims for several comorbidities. Acromegaly drugs represented 16.3% of the acromegaly cohort's total costs. Total health benefit costs were $54 821 higher (P < .05) for patients compared with controls, with direct costs representing 79.8% of the difference. Total indirect costs were higher for patients with acromegaly, with short-term and long-term disability comprising most of the difference between the acromegaly and control groups. Patients with acromegaly had significantly more short-term disability days than controls, but total sick days were similar for the 2 groups.
The presence of acromegaly was associated with increased direct and indirect employee health benefit costs and increased work absenteeism.
肢端肥大症与发病率和死亡率的增加有关。关于这些患者的医疗保健利用情况和成本，数据有限。本研究评估了肢端肥大症对员工健康福利（直接和间接）成本和旷工的影响。
对来自美国员工数据库的肢端肥大症患者的药物和医疗索赔及雇主数据（2010 年 1 月至 2019 年 4 月）进行回顾性分析，并与匹配对照进行比较。在诊断后（或匹配）日期后的 12 个月内跟踪患者的索赔情况。使用单独的两部分回归模型分析结果，控制临床、人口统计学和与工作相关的变量。
共确定了 47 例肢端肥大症患者和 940 例对照。队列在大多数人口统计学和工作相关变量方面相似。肢端肥大症患者的 Charlson 合并症指数评分明显更高，并且几种合并症的索赔发生率更高。肢端肥大症药物占肢端肥大症队列总费用的 16.3%。与对照组相比，患者的总健康福利费用高出 54821 美元（P <.05），直接费用占差异的 79.8%。肢端肥大症患者的总间接费用较高，短期和长期残疾构成了肢端肥大症组和对照组之间的大部分差异。与对照组相比，肢端肥大症患者的短期残疾天数明显更多，但两组的总病假天数相似。
肢端肥大症的存在与直接和间接员工健康福利成本的增加以及工作缺勤的增加有关。
