Genentech Inc, South San Francisco, CA, USA.
Genesis Research, Hoboken, NJ, USA.
J Med Econ. 2022 Jan-Dec;25(1):722-729. doi: 10.1080/13696998.2022.2076997.
To quantify healthcare resource utilization (HRU) and costs by disease stage in individuals with Huntington's disease (HD) in a US population.
This retrospective cohort study used administrative claims data from the IBM MarketScan Commercial, Multi-State Medicaid, and Medicare Supplemental Databases between 1 January 2009 and 31 December 2018. Individuals with an HD claim between 1 January 2010 and 31 December 2017 were selected. Index date was the date of first HD diagnosis. Individuals were required to have continuous enrollment for ≥ 12 months pre-index, 3 months post-index, and have no pre-index HD claims. All-cause HRU and costs per patient per month (PPPM) (overall and stratified by disease stage) were assessed for individuals with HD.
A total of 2,669 individuals with HD were identified. Of these, 1,432 (53.7%), 689 (25.8%), and 548 (20.5%) had early-, middle-, and late-stage HD at baseline, respectively. Mean HRU PPPM by post-index HD stage increased with disease stage for outpatient visits, pharmacy claims, and HD-related pharmacy claims ( < 0.05 for all). Mean inpatient visits and emergency room visits PPPM were highest in individuals with middle-stage HD ( <0.05 for all). Mean total all-cause healthcare cost PPPM for individuals with HD was $2,889, and it was significantly higher in middle-stage individuals, at $7,988, compared with early- and late-stage individuals, at $3,726 and $5,125, respectively; <0.0001.
In the absence of disease staging information in administrative claims data, staging was based on the presence of clinical markers in claims. Our evaluations didn't include the indirect costs of HD, which may be substantial as HD typically affects people at their peak earning potential.
HRU and costs of care are high among individuals with HD, particularly among those with middle- and late-stage disease. This indicates that the disease burden in HD increases with disease stage, highlighting the need for interventions that can slow or prevent disease progression.
在一个美国人群体中，按疾病阶段量化亨廷顿病（HD）患者的医疗资源利用（HRU）和成本。
本回顾性队列研究使用了 IBM MarketScan 商业、多州医疗补助和 Medicare 补充数据库从 2009 年 1 月 1 日至 2018 年 12 月 31 日的行政索赔数据。选择了 2010 年 1 月 1 日至 2017 年 12 月 31 日期间有 HD 索赔的个人。索引日期为首次 HD 诊断日期。要求患者在索引前至少有 12 个月的连续入组，索引后 3 个月，并在索引前没有 HD 索赔。对 HD 患者进行了每位患者每月（PPPM）的所有原因 HRU 和成本（整体和按疾病阶段分层）评估。
共确定了 2669 名 HD 患者。其中，基线时分别有 1432 名（53.7%）、689 名（25.8%）和 548 名（20.5%）患有早期、中期和晚期 HD。按索引后 HD 阶段划分，门诊就诊、药房配药和与 HD 相关的药房配药的每月 PPPM 呈 HRU 递增趋势（所有均 <0.05）。中期 HD 患者的住院和急诊就诊 PPPM 最高（所有均 <0.05）。HD 患者的平均总所有原因医疗保健成本 PPPM 为 2889 美元，中期患者的费用为 7988 美元，明显高于早期和晚期患者的 3726 美元和 5125 美元；<0.0001。
在行政索赔数据中没有疾病分期信息的情况下，分期是基于索赔中的临床标志物。我们的评估不包括 HD 的间接成本，由于 HD 通常发生在人们处于最佳收入潜力的时期，因此该成本可能很高。
HD 患者的 HRU 和护理成本很高，尤其是中晚期疾病患者。这表明 HD 患者的疾病负担随疾病阶段的增加而增加，这突出表明需要采取干预措施来减缓或预防疾病进展。
