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Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA
BACKGROUND: The purpose of this study was to describe comorbidities, healthcare costs, and resource utilization among patients with chronic non-infectious uveitis initiating corticosteroid, immunosuppressants, or biologics. In this retrospective cohort study, patients with a non-infectious uveitis d...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830557/ https://www.ncbi.nlm.nih.gov/pubmed/24195808 http://dx.doi.org/10.1186/1869-5760-3-64 |
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author | Chu, David S Johnson, Scott J Mallya, Usha G Davis, Matthew R Sorg, Rachael A Duh, Mei Sheng |
author_facet | Chu, David S Johnson, Scott J Mallya, Usha G Davis, Matthew R Sorg, Rachael A Duh, Mei Sheng |
author_sort | Chu, David S |
collection | PubMed |
description | BACKGROUND: The purpose of this study was to describe comorbidities, healthcare costs, and resource utilization among patients with chronic non-infectious uveitis initiating corticosteroid, immunosuppressants, or biologics. In this retrospective cohort study, patients with a non-infectious uveitis diagnosis and continuous insurance coverage during a 6-month baseline were selected from a privately insured claims database with 80.7 million enrollees. Index dates were defined as the first prescription/administration of a corticosteroid, immunosuppressant, or biologic between 2003 and 2009. Comorbidities, healthcare costs, and utilization were analyzed in a per-member-per-month (PMPM) framework to account for varying between-patient treatment periods, defined as continuous medication use within the same class. Wilcoxon rank-sum and chi-square tests were used for comparisons of costs and categorical outcomes. RESULTS: Patients on corticosteroids (N = 4,568), immunosuppressants (N = 5,466), and biologics (N = 1,694) formed the study population. Baseline PMPM inpatient admission rates were 0.029 for patients on corticosteroids, 0.044 for patients on immunosuppressants, and 0.045 for patients on biologics (p < 0.001 immunosuppressants or biologics versus corticosteroids); during treatment, PMPM inpatient admissions increased to 0.044 and 0.048 for patients taking corticosteroids and immunosuppressants, respectively, but decreased to 0.024 for patients taking biologics (p < 0.001 versus corticosteroids and p = 0.003 versus immunosuppressants). Baseline average PMPM costs for patients taking corticosteroids, immunosuppressants, and biologics were US$935, US$1,738, and US$1,439 (p < 0.001 between groups), while on-treatment PMPM costs excluding drug costs increased to US$1,129 for patients taking corticosteroids but lowered to US$1,592 for patients taking immunosuppressants, and US$918 for patients taking biologics (p < 0.001 versus corticosteroids or immunosuppressants). CONCLUSIONS: There is significant economic burden associated with existing treatments of uveitis. Corticosteroids may be overused as a treatment for uveitis. |
format | Online Article Text |
id | pubmed-3830557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer |
record_format | MEDLINE/PubMed |
spelling | pubmed-38305572013-11-18 Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA Chu, David S Johnson, Scott J Mallya, Usha G Davis, Matthew R Sorg, Rachael A Duh, Mei Sheng J Ophthalmic Inflamm Infect Original Research BACKGROUND: The purpose of this study was to describe comorbidities, healthcare costs, and resource utilization among patients with chronic non-infectious uveitis initiating corticosteroid, immunosuppressants, or biologics. In this retrospective cohort study, patients with a non-infectious uveitis diagnosis and continuous insurance coverage during a 6-month baseline were selected from a privately insured claims database with 80.7 million enrollees. Index dates were defined as the first prescription/administration of a corticosteroid, immunosuppressant, or biologic between 2003 and 2009. Comorbidities, healthcare costs, and utilization were analyzed in a per-member-per-month (PMPM) framework to account for varying between-patient treatment periods, defined as continuous medication use within the same class. Wilcoxon rank-sum and chi-square tests were used for comparisons of costs and categorical outcomes. RESULTS: Patients on corticosteroids (N = 4,568), immunosuppressants (N = 5,466), and biologics (N = 1,694) formed the study population. Baseline PMPM inpatient admission rates were 0.029 for patients on corticosteroids, 0.044 for patients on immunosuppressants, and 0.045 for patients on biologics (p < 0.001 immunosuppressants or biologics versus corticosteroids); during treatment, PMPM inpatient admissions increased to 0.044 and 0.048 for patients taking corticosteroids and immunosuppressants, respectively, but decreased to 0.024 for patients taking biologics (p < 0.001 versus corticosteroids and p = 0.003 versus immunosuppressants). Baseline average PMPM costs for patients taking corticosteroids, immunosuppressants, and biologics were US$935, US$1,738, and US$1,439 (p < 0.001 between groups), while on-treatment PMPM costs excluding drug costs increased to US$1,129 for patients taking corticosteroids but lowered to US$1,592 for patients taking immunosuppressants, and US$918 for patients taking biologics (p < 0.001 versus corticosteroids or immunosuppressants). CONCLUSIONS: There is significant economic burden associated with existing treatments of uveitis. Corticosteroids may be overused as a treatment for uveitis. Springer 2013-11-06 /pmc/articles/PMC3830557/ /pubmed/24195808 http://dx.doi.org/10.1186/1869-5760-3-64 Text en Copyright © 2013 Chu et al.; licensee Springer. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Chu, David S Johnson, Scott J Mallya, Usha G Davis, Matthew R Sorg, Rachael A Duh, Mei Sheng Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title | Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title_full | Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title_fullStr | Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title_full_unstemmed | Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title_short | Healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the USA |
title_sort | healthcare costs and utilization for privately insured patients treated for non-infectious uveitis in the usa |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830557/ https://www.ncbi.nlm.nih.gov/pubmed/24195808 http://dx.doi.org/10.1186/1869-5760-3-64 |
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