Genentech, Inc, South San Francisco, CA, USA.
Genesis Research, Hoboken, NJ, USA.
J Med Econ. 2022 Jan-Dec;25(1):1061-1067. doi: 10.1080/13696998.2022.2111910.
Cardiovascular disease (CVD) increases the risk of complications from respiratory viruses, including influenza. Moreover, respiratory viruses may increase the risk of CV events. Antiviral medication may reduce healthcare resource utilization (HRU), but more data is needed in CVD populations to explore relationships between influenza antiviral treatment, CVD-related complications, HRU, and costs.
This retrospective claims analysis examined data extracted from IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases during three influenza seasons: 2016-2017, 2017-2018, or 2018-2019. Propensity score matching was used to compare HRU outcomes and costs among CVD patients treated with influenza antivirals and untreated patients.
Across all influenza seasons, patients with CVD and influenza who received antiviral treatment had fewer all-cause emergency department (ED) visits ( < .01), respiratory-related HRU ( < .01), respiratory-related outpatient and ED visits (both < .01), CVD-related HRU ( < .01), heart failure-related HRU visits ( < .01), and kidney failure-related HRU ( < .01) 180 days post-treatment fill date than CVD patients untreated for influenza. CVD patients treated with antivirals also had a lower mean number of all-cause inpatient, outpatient, and ED visits and days of stay (all < .01) and fewer mean respiratory-related outpatient and ED visits (both < .01). HRU patterns were generally consistent over time and across individual influenza seasons. Finally, treated CVD patients incurred lower all-cause outpatient costs 180 days post-treatment fill date ( < .05) than CVD patients untreated for influenza.
CVD patients who contract influenza and take antiviral medication have fewer short- and long-term influenza-related complications and less overall HRU compared with CVD patients who were not prescribed antiviral treatments. Antiviral treatment may be an important tool in reducing complications in CVD patients with influenza.
心血管疾病 (CVD) 会增加呼吸道病毒(包括流感)引发并发症的风险。此外,呼吸道病毒可能会增加心血管事件的风险。抗病毒药物可能会减少医疗保健资源的利用 (HRU),但在 CVD 人群中需要更多的数据来探索流感抗病毒治疗、与 CVD 相关的并发症、HRU 和成本之间的关系。
这项回顾性索赔分析检查了从 IBM MarketScan 商业索赔和遭遇以及医疗保险补充和协调福利数据库中提取的数据,这些数据来自三个流感季节:2016-2017 年、2017-2018 年或 2018-2019 年。使用倾向评分匹配来比较 CVD 患者接受流感抗病毒治疗和未接受治疗的患者的 HRU 结果和成本。
在所有流感季节中,患有 CVD 和流感且接受抗病毒治疗的患者的全因急诊就诊次数( < .01)、呼吸道相关 HRU( < .01)、呼吸道相关门诊和急诊就诊次数(均 < .01)、CVD 相关 HRU( < .01)、心力衰竭相关 HRU 就诊次数( < .01)和肾脏衰竭相关 HRU( < .01)在治疗后填充日期后 180 天均少于未接受流感抗病毒治疗的 CVD 患者。接受抗病毒治疗的 CVD 患者的全因住院、门诊和急诊就诊次数和住院天数也明显减少(均 < .01),呼吸道相关门诊和急诊就诊次数也明显减少(均 < .01)。HRU 模式在时间上和各个流感季节中基本保持一致。最后,接受治疗的 CVD 患者在治疗后填充日期后 180 天的全因门诊费用较低( < .05),而未接受流感抗病毒治疗的 CVD 患者则较高。
与未接受抗病毒治疗的 CVD 患者相比,患有流感并接受抗病毒药物治疗的 CVD 患者在短期和长期流感相关并发症和整体 HRU 方面均较少。抗病毒治疗可能是减少流感合并 CVD 患者并发症的重要工具。