Neuberger Edward E, To Tu My, Seetasith Arpamas, Arndorfer Stella M, Wallick Chris J
Seagen, Bothell, WA, (current address: Seagen, Bothell, WA), Evidence For Access, US Medical Affairs, Genentech, Inc., South San Francisco, California.
Real World Evidence Analytics, Genesis Research, Hoboken, New Jersey.
ACR Open Rheumatol. 2022 Jul;4(7):631-639. doi: 10.1002/acr2.11441. Epub 2022 May 12.
Patients with rheumatoid arthritis (RA) are vulnerable to severe complications of influenza. We assessed whether health care resource use (HRU) and costs differed between patients with RA and influenza who received antiviral medication compared with matched patients with RA and influenza not receiving antiviral therapy.
This was a retrospective US health insurance claims analysis over three influenza seasons (each October to April) in 2016-2019. Adults with RA and a subsequent diagnosis of influenza were included. Treated patients (receiving antiviral influenza treatment within 2 days of diagnosis) and untreated patients were propensity score matched using baseline covariates. HRU and costs were assessed for inpatient, emergency department (ED), and outpatient visits and compared between cohorts using χ tests and t tests.
After matching, 2638 treated and 1319 untreated patients were included. For treated versus untreated patients, the mean number of all-cause outpatient visits was 0.96 versus 1.21 during 14 days of follow-up (P < 0.001) and 1.94 versus 2.24 over 28 days (P = 0.001), respectively. Over 28 days, the mean number of all-cause ED visits was lower among treated (0.23) than untreated (0.30) patients (P = 0.042). The mean number of respiratory-related outpatient visits was significantly lower for treated versus untreated patients, and mean costs for these visits were $17.89 versus $35.27 over 14 days (P < 0.001) and $28.92 versus $48.77 over 28 days (P < 0.001) for treated versus untreated patients, respectively.
Our findings demonstrate that prompt antiviral treatment after influenza diagnosis may reduce HRU and costs in patients with RA.
类风湿关节炎(RA)患者易发生流感严重并发症。我们评估了接受抗病毒药物治疗的RA合并流感患者与匹配的未接受抗病毒治疗的RA合并流感患者相比,医疗资源使用(HRU)和费用是否存在差异。
这是一项对2016 - 2019年三个流感季节(每年10月至次年4月)美国医疗保险索赔的回顾性分析。纳入患有RA且随后诊断为流感的成年人。使用基线协变量对接受治疗的患者(诊断后2天内接受抗流感病毒治疗)和未接受治疗的患者进行倾向评分匹配。评估住院、急诊科(ED)和门诊就诊的HRU和费用,并使用χ检验和t检验在队列之间进行比较。
匹配后,纳入2638例接受治疗的患者和1319例未接受治疗的患者。对于接受治疗与未接受治疗的患者,在14天的随访期间,全因门诊就诊的平均次数分别为0.96次和1.21次(P < 0.001),在28天内分别为1.94次和2.24次(P = 0.001)。在28天内,接受治疗的患者(0.23次)全因急诊科就诊的平均次数低于未接受治疗的患者(0.30次)(P = 0.042)。接受治疗的患者与未接受治疗的患者相比,呼吸道相关门诊就诊的平均次数显著更低,这些就诊的平均费用在14天内分别为17.89美元和35.27美元(P < 0.001),在28天内分别为28.92美元和48.77美元(P < 0.001)。
我们的研究结果表明,流感诊断后及时进行抗病毒治疗可能会降低RA患者的HRU和费用。