Dataset Information

Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.

ABSTRACT:

Objectives

Hidradenitis suppurativa (HS) causes substantial morbidity and quality-of-life impairment. We examined demographic/clinical characteristics of patients with HS and treatment patterns, prevalence and healthcare resource utilisation/expenditures related to HS in the real-world.

Design

Retrospective claims data of MarketScan Commercial, Medicare Supplemental and Medicaid databases (2009-2014).

Setting

USA.

Participants

Patients aged ?12 years with ?3 non-diagnostic outpatient or inpatient claims with an HS diagnosis code and ?12 months continuous enrolment with medical and pharmacy benefits before (preindex) and after (postindex) the earliest diagnosis of HS (index) were included.

Results

There were 11?325 Commercial/Medicare patients (mean age 37.4 years) and 5164 Medicaid patients (mean age 28.3 years). HS was more common in Medicaid than Commercial/Medicare patients (0.301% and 0.098%, respectively, in 2014). Cellulitis and psychiatric disorders were the most common comorbidities and oral antibiotics and narcotics were the most frequently prescribed drugs preindex, with ?10% increase postindex in both populations. HS-related inpatient costs decreased while outpatient costs increased from preindex to postindex. Medicaid patients had several risk factors that may be associated with poor outcomes (eg, high rates of prescription pain medication use, comorbidities, drug discontinuation/interruption/holiday, emergency department (ED) visits and hospitalisation).

Conclusions

Commercial/Medicare and Medicaid HS beneficiaries experience high comorbidity burden but use different treatment modalities to manage HS. Results suggest a substantial unmet need exists among this patient population, with Medicaid patients experiencing a particularly high burden of disease and expensive healthcare resource utilisation.

SUBMITTER: Marvel J

PROVIDER: S-EPMC6797383 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.

Marvel Jessica J Vlahiotis Anna A Sainski-Nguyen Amy A Willson Tina T Kimball Alexandra A

BMJ open 20190930 9

<h4>Objectives</h4>Hidradenitis suppurativa (HS) causes substantial morbidity and quality-of-life impairment. We examined demographic/clinical characteristics of patients with HS and treatment patterns, prevalence and healthcare resource utilisation/expenditures related to HS in the real-world.<h4>Design</h4>Retrospective claims data of MarketScan Commercial, Medicare Supplemental and Medicaid databases (2009-2014).<h4>Setting</h4>USA.<h4>Participants</h4>Patients aged ≥12 years with ≥3 non-diag ...[more]

PMID: 31575575

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Project description:IntroductionHidradenitis suppurativa (HS) is a chronic, autoinflammatory skin disease associated with many comorbidities. One biologic (adalimumab) is approved for HS. This study assessed the sociodemographic characteristics, comorbidities, treatment patterns, healthcare resource utilization (HCRU) and associated costs of patients with HS following biologic approval.MethodsThis non-interventional, retrospective cohort study involved adult (≥ 18 years) and adolescent (12-17 years) patients diagnosed with HS in the United States (US) using Optum's de-identified Clinformatics® Data Mart Database during the period 1 January 2016 to 31 December 2018.ResultsOf 42,843 identified patients, 10,909 met the incident HS patient criteria (10,230 adults, 628 adolescents, 51 patients aged <12 years). Patients were mostly diagnosed by a general practitioner/pediatrician (adults: 41.6%; adolescents: 39.6%) or dermatologist (adults: 22.1%; adolescents: 30.6%). Commonly reported Charlson comorbidities at pre-index in adult patients were diabetes without complications (20.4%), chronic pulmonary disease (16.4%) and diabetes with complications (9.0%), and the most frequent Elixhauser comorbidities were uncomplicated hypertension (38.3%), obesity (22.5%), uncomplicated diabetes (19.0%) and depression (17.4%). The burden of comorbidities generally increased over time after diagnosis in both adults and adolescents. HS-related surgical procedures were uncommon in the 2-years post-index period: an incision and drainage procedure was reported in 7.6% of adults and 6.4% of adolescents. Patients were predominantly treated with both topical and systemic antibiotic treatments (adults: 25.0% and 65.1%, respectively; adolescents: 41.7% and 74.5%, respectively). Biologic prescription was higher in adults than adolescents (3.5% vs. 1.8%). Total healthcare costs for adult and adolescent patients in the 2-years post-index period were US$42,143 and US$16,057, respectively, with outpatient costs accounting for the majority of these costs (US$20,980 and US$8408, respectively).ConclusionIn adult and adolescent patients with HS, comorbidity burden continues to increase after diagnosis. All-cause and HS-specific HCRU and costs are high in adults and adolescents with HS. These findings support the need for a multidisciplinary comprehensive care strategy for patients with HS.

Project description:ImportanceThe overall comorbidity burden among patients with hidradenitis suppurativa (HS) has not been systematically evaluated.ObjectivesTo investigate the standardized overall comorbidity burden among patients with HS and to compare it with the comorbidity burden in patients with psoriasis and a control group.Design, setting, and participantsA cross-sectional analysis was conducted of 5306 patients with HS, 14 037 patients with psoriasis, and 1 733 810 controls identified using electronic health records data from October 1, 2013, through October 1, 2018.Main outcome and measureThe primary outcome was the mean Charlson Comorbidity Index (CCI) score.ResultsEach matched cohort had 3818 patients (2789 women and 1029 men; mean [SD] age, 45.7 [15.0]). Before matching, the overall mean (SD) CCI score was highest among the psoriasis cohort (2.33 [3.13]), followed by the HS cohort (1.80 [2.79]) and control cohort (1.26 [2.35]). In matched analyses, the overall mean (SD) CCI score was highest among the HS cohort (1.95 [2.96]), followed by the psoriasis cohort (1.47 [2.43]; P < .001) and control cohort (0.95 [1.99]; P < .001) patients. A total of 516 patients with HS (13.5%) had an overall mean CCI score of 5 or greater. Mean CCI score was highest for patients with HS across all sex, race, and age groups. The most common comorbidities among patients with HS were chronic pulmonary disease (1540 [40.3%]), diabetes with chronic complications (365 [9.6%]), diabetes without chronic complications (927 [24.3%]), and mild liver disease (455 [11.9%]). Patients with HS with a CCI score of 5 or greater had 4.97 (95% CI, 1.49-16.63) times the adjusted risk of 5-year mortality compared with patients with HS with a CCI score of zero.Conclusions and relevancePatients with HS have a higher overall comorbidity burden compared with patients with psoriasis and a control group. A significant proportion of patients with HS have CCI scores of 5 or greater, which are associated with increased mortality. This degree of comorbidity burden may warrant multidisciplinary implementation of routine screening measures.

Project description:IntroductionData are lacking on severe asthma burden in elderly people in Japan. We assessed the prevalence and clinical/economic burden of severe asthma and asthma-related hospitalizations in elderly and younger Japanese patients.MethodsThis retrospective study analyzed outpatient claims data and inpatient hospital discharge records among patients aged ≥ 15 years with asthma (defined as ≥ 2 prescriptions of inhaled corticosteroids [ICS] or ICS/long-acting beta-agonists [LABA]) between 1 July 2014 and 30 June 2017. We analyzed the outpatient visit assessment population with severe asthma (≥ 240-day prescription of high-dose ICS and ≥ 90-day prescription of ≥ 1 additional controllers) and the asthma-related hospitalization population (≥ 1 hospital admission[S] with a primary diagnosis of asthma/status asthmaticus and use of systemic corticosteroids) over a 1-year observation period before the date of each patient's latest asthma prescription or asthma-related hospitalization within the study period. The primary outcome was the proportion of elderly (≥ 65 years) and younger (15-39 and 40-64 years) patients among the outpatient visit assessment population. Secondary outcomes included outpatient and inpatient characteristics, asthma-related healthcare resource utilization, and asthma-associated costs, by age group.ResultsOf the outpatient visit assessment population (n = 35,742), 4211 had severe asthma, with the prevalence of 8.2%, 12.8%, and 12.4% for the 15-39, 40-64, and ≥ 65 years age groups, respectively. Elderly versus younger outpatients with severe asthma had higher cumulative oral corticosteroid doses. Among both outpatient visit assessment population and hospitalization assessment population, elderly versus younger outpatients with severe asthma or asthma-related hospitalizations had more comorbidities, required more biological, hematological, immunological, and microbiological tests, and incurred higher asthma-associated costs.ConclusionsIn addition to reaffirming the higher prevalence of severe asthma in Japanese patients ≥ 40 years versus those < 40 years of age, our results demonstrated higher clinical and economic burden in elderly versus younger patients.

Project description:IntroductionHidradenitis suppurativa (HS) has a profound negative impact on patients' health-related quality of life (HRQoL). Here we summarize the evidence on HRQoL and Patient Reported Outcomes (PROs) in patients with HS in real-world settings by conducting a systematic literature review (SLR) of observational studies.MethodsData sources included MEDLINE, Embase & PsycINFO between January 1, 2010 and August 29, 2021, and conference proceedings between 2019 and 2021. Identified abstracts were reviewed and screened independently by two reviewers. Eligibility criteria included patients with HS of any severity, sample size ≥ 100, reporting PROs including HRQoL measures. Included studies were critically appraised.ResultsFifty-eight observational studies matched inclusion criteria. Dermatology Life Quality Index (DLQI) was the most commonly utilized instrument: 57% of included studies reported mean baseline DLQI scores, ranging between 8.4 and 16.9, indicating a very large impact on the patients' HRQoL. Higher scores were reported with increasing disease severity and among female patients. Pain was assessed mostly by an 11-point (0-10) numeric rating scale (NRS) with a mean baseline score ranging from 3.6 to 7.7 indicating moderate to high pain levels. There was a negative impact of HS on patients' psychological well-being, based on PRO scores related to depression and anxiety. A high proportion of sexual dysfunction was reported, with a larger impact on women than men. Work productivity and leisure activity were consistently found to be impaired in patients with HS.ConclusionsAll included studies reported a negative impact of HS on patients' lives. A diverse set of disease- and non-disease-specific PRO instruments were utilized highlighting the need for more consistent use of HS-specific validated PRO instruments to assess the impact of HS on the different aspects of patients' HRQoL to allow for data to be more meaningfully interpreted and compared in real-world settings. Patients with HS need better disease management approaches that address the observed low quality of life.

Project description:ImportanceHidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent inflamed nodular lesions and is associated with multiple comorbidities; previous studies have been of cross-sectional design, and the temporal association of HS with multiple comorbidities remains undetermined.ObjectiveTo evaluate and characterize disease trajectories in patients with HS using population-wide disease registry data.Design, setting, and participantsThis retrospective registry-based cohort study included the entire Danish population alive between January 1, 1994, and April 10, 2018 (7 191 519 unique individuals). Among these, 14 488 Danish inhabitants were diagnosed with HS or fulfilled diagnostic criteria identified through surgical procedure codes.ExposuresCitizens of Denmark with a diagnosis code of HS as defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) or as identified through surgical procedures.Main outcomes and measuresDisease trajectories experienced more frequently by patients with HS than by the overall Danish population. Strength of associations between disease co-occurrences was evaluated using relative risk (RR). All significant disease pairs were tested for directionality using a binomial test, and pairs with directionality were merged into disease trajectories of 3 consecutive diseases. Numerous disease trajectories were combined into a disease progression network showing the most frequent disease paths over time for patients with HS.ResultsA total of 11 929 individuals were identified by ICD-10 diagnosis codes (8392 [70.3%] female; mean [SD] age, 37.72 [13.01] years), and 2791 were identified by procedural codes (1686 [60.4%] female; mean [SD] age, 37.38 [15.83]). The set of most common temporal disease trajectories included 25 diagnoses and had a characteristic appearance in which genitourinary, respiratory, or mental and behavioral disorders preceded the diagnosis of HS and chronic obstructive pulmonary disease (604 cases [4.2%]; RR, 1.57; 95% CI, 1.55-1.59; P < .001), pneumonia (827 [5.7%]; RR, 1.18; 95% CI, 1.15-1.20; P < .001), and acute myocardial infarction (293 [2.0%]; RR, 1.37; 95% CI, 1.35-1.39; P < .001) developed after the diagnosis.Conclusions and relevanceThe findings suggest that patients with newly diagnosed HS may have a high frequency of manifest type 1 diabetes and subsequent high risk of acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease.

Dataset Information

Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.

Similar Datasets

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