Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA.
Analysis Group, Inc., Boston, Massachusetts, USA.
Neurogastroenterol Motil. 2022 Sep;34(9):e14366. doi: 10.1111/nmo.14366. Epub 2022 Mar 30.
Due to limited treatment options, many patients with diabetic gastroparesis (DG) or idiopathic gastroparesis (IG) experience inadequate symptom control resulting in increased health-care resource utilization (HRU) and associated costs. We compared all-cause HRU and health-care costs over the 3 years after patients' first gastroparesis diagnosis with that of matched controls without gastroparesis.
Newly diagnosed adults with DG or IG were identified in Optum's de-identified Clinformatics Data Mart Database (Q1-2007 to Q1-2019). Patients with DG/IG were matched 1:1 to controls using a mixed approach of exact matching and propensity score matching. The index date was the first gastroparesis diagnosis for cases or randomly selected for controls. All-cause HRU and direct health-care costs per person-year (PPY) were compared between DG/IG cases and controls in Years 1-3 post-index.
Demographics and comorbidities were balanced between patients with gastroparesis (n = 18,015 [DG]; n = 14,305 [IG]) and controls. In each of the Years 1-3 post-index, patients with DG or IG had significantly higher annual HRU and costs versus controls (mean total cost differences PPY: DG Year 1 $34,885, Year 2 $28,071, Year 3 $25,606; IG Year 1 $23,176, Year 2 $16,627, Year 3 $14,396) (all p < 0.05). Across all 3 years, DG/IG cohorts had approximately twice the costs of controls. HRU and costs were highest in Year 1 post-index for both DG and IG.
CONCLUSIONS & INFERENCES: The economic burden of gastroparesis remains high several years after diagnosis, emphasizing the need for chronic treatment to effectively manage symptoms and consequently reduce the burden of this disorder.
由于治疗选择有限,许多糖尿病性胃轻瘫(DG)或特发性胃轻瘫(IG)患者的症状控制不足,导致医疗资源利用(HRU)增加和相关成本增加。我们比较了患者首次胃轻瘫诊断后 3 年内的全因 HRU 和医疗保健费用与无胃轻瘫的匹配对照。
在 Optum 的去识别 Clinformatics Data Mart 数据库(2007 年第一季度至 2019 年第一季度)中确定了新诊断的 DG 或 IG 成年患者。使用精确匹配和倾向评分匹配的混合方法对 DG/IG 患者进行 1:1 与对照匹配。索引日期为病例的首次胃轻瘫诊断日期或对照的随机选择日期。在索引后第 1-3 年,比较 DG/IG 病例和对照的全因 HRU 和人均每年(PPY)直接医疗保健费用。
在胃轻瘫患者(n=18015[DG];n=14305[IG])和对照之间,人口统计学和合并症得到了平衡。在索引后第 1-3 年的每一年,DG 或 IG 患者的年度 HRU 和费用均明显高于对照组(每年总费用差异 PPY:DG 年 1 为 34885 美元,年 2 为 28071 美元,年 3 为 25606 美元;IG 年 1 为 23176 美元,年 2 为 16627 美元,年 3 为 14396 美元)(均 P<0.05)。在所有 3 年中,DG/IG 队列的费用约为对照组的两倍。对于 DG 和 IG,在索引后第 1 年,HRU 和费用最高。
胃轻瘫的经济负担在诊断后几年仍很高,这强调了需要进行慢性治疗以有效控制症状,从而减轻这种疾病的负担。