Genentech Inc, South San Francisco, CA, USA.
PHAR (Partnership for Health Analytic Research), Beverly Hills, CA, USA.
J Med Econ. 2023 Jan-Dec;26(1):811-820. doi: 10.1080/13696998.2023.2222561.
To provide more recent estimates of healthcare utilization and costs in Huntington's disease (HD) in the Medicaid population.
This retrospective analysis used administrative claims data for HD beneficiaries (≥1 HD claim; ICD-9-CM 333.4) from Medicaid Analytic eXtract data files from 1 January 2010-31 December 2014. The date of the first HD claim during the identification period (1 January 2011-31 December 2013) was assigned as the index date. If a beneficiary had multiple HD claims during the identification period, one was randomly chosen as the index date. Beneficiaries were required to be continuously enrolled in fee-for-service plans during the 1-year pre-index and post-index periods. Medicaid beneficiaries without HD were drawn from a 100% random sample and matched (3:1) to those with HD. Beneficiaries were classified by disease stage (early/middle/late). All-cause and HD-related (any utilization related to HD diagnosis or symptoms associated with HD) healthcare utilization and costs were reported.
A total of 1,785 beneficiaries without HD were matched to 595 beneficiaries with HD (139 early-, 78 middle-, and 378 late-stage). The mean (SD) annual total costs were higher for beneficiaries with HD than beneficiaries without HD ($73,087 [$75,140] vs. $26,834 [$47,659], <.001) and driven by inpatient costs ($45,190 [$48,185] vs. $13,808 [$39,596], <.001). Total healthcare costs were highest among beneficiaries with late-stage HD (mean [SD] cost: $22,797 [$31,683] for early-stage HD vs. $55,294 [$129,290] for middle-stage HD vs. $95,251 [$60,197] for late-stage HD; <.001).
Administrative claims are intended for billing purposes and subject to coding errors. This study did not address functional status, which may provide further insight to late-stage and end-of-life burden of HD, and indirect costs.
Medicaid beneficiaries with HD have higher acute healthcare utilization and costs compared to beneficiaries without HD, which tend to increase with disease progression, indicating that HD beneficiaries at later disease stages have greater burden.
提供医疗保健利用和成本在亨廷顿氏病（HD）在医疗补助的最新估计。
本回顾性分析使用行政索赔数据的医疗补助受益人的 HD（≥ 1 HD 索赔；ICD-9-CM 333.4）从医疗补助分析提取数据文件从 1 月 1 日 2010-12 月 31 日 2014 年。第一 HD 索赔的日期在鉴定期内（1 月 1 日 2011-12 月 31 日 2013 年）被指定为索引日期。如果受益人有多个 HD 索赔期间的鉴定期内，一个是随机选择作为索引日期。受益人必须在 1 年的预索引和后索引期间持续注册服务计划。没有 HD 的医疗补助受益人是从一个 100%的随机样本和匹配（3:1），以那些与 HD。受益人按疾病阶段（早期/中期/晚期）分类。所有的原因和 HD 相关的（任何利用与 HD 诊断或相关症状亨廷顿氏病）的医疗保健的利用和成本进行了报道。
共有 1785 名没有 HD 的受益人与 595 名有 HD 的受益人相匹配（139 例早期，78 例中期，378 例晚期）。年平均（SD）总成本较高的受益人比没有 HD 的受益人（73087 美元（75140 美元）与 26834 美元（47659 美元），<0.001），并由住院成本驱动（45190 美元（48185 美元）与 13808 美元（39596 美元），<0.001）。总医疗保健成本是最高的受益人与晚期 HD（平均[SD]成本：22797 美元（31683 美元）为早期 HD 与 55294 美元（95251 美元）为中期 HD 与 95251 美元（60197 美元）为晚期 HD；<0.001）。
行政索赔是为了计费的目的，并受到编码错误。本研究没有解决功能状态，这可能提供进一步洞察晚期和亨廷顿氏病的生命终末期的负担，以及间接成本。
医疗补助受益人与 HD 有较高的急性医疗保健的利用和成本比没有 HD 的受益人，这往往随着疾病的进展而增加，这表明 HD 受益人在后期疾病阶段有更大的负担。
