Cargando…

Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States

INTRODUCTION: Few studies have described chronic idiopathic/spontaneous urticaria (CIU/CSU) healthcare burden in adults, while this information remains largely unknown in children. We aimed to describe treatment patterns, healthcare resource utilization (HRU), and costs in CIU/CSU pediatric patients...

Descripción completa

Detalles Bibliográficos
Autores principales: Williams, Paul V., Kavati, Abhishek, Pilon, Dominic, Xiao, Yongling, Zhdanava, Maryia, Balp, Maria-Magdalena, Lefebvre, Patrick, Ortiz, Benjamin, Hernandez-Trujillo, Vivian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825330/
https://www.ncbi.nlm.nih.gov/pubmed/29429043
http://dx.doi.org/10.1007/s13555-018-0225-6
_version_ 1783302173541531648
author Williams, Paul V.
Kavati, Abhishek
Pilon, Dominic
Xiao, Yongling
Zhdanava, Maryia
Balp, Maria-Magdalena
Lefebvre, Patrick
Ortiz, Benjamin
Hernandez-Trujillo, Vivian
author_facet Williams, Paul V.
Kavati, Abhishek
Pilon, Dominic
Xiao, Yongling
Zhdanava, Maryia
Balp, Maria-Magdalena
Lefebvre, Patrick
Ortiz, Benjamin
Hernandez-Trujillo, Vivian
author_sort Williams, Paul V.
collection PubMed
description INTRODUCTION: Few studies have described chronic idiopathic/spontaneous urticaria (CIU/CSU) healthcare burden in adults, while this information remains largely unknown in children. We aimed to describe treatment patterns, healthcare resource utilization (HRU), and costs in CIU/CSU pediatric patients, as well as to compare HRU and costs in CIU/CSU and CIU/CSU-free pediatric patients. METHODS: Medicaid claims from four states (09/01/2013–03/31/2016) were used to identify patients less than 12 years old. The CIU/CSU cohort included patients with either at least two claims for idiopathic, other, or unspecified urticaria at least 6 weeks apart, or at least one claim for urticaria and at least one claim for angioedema at least 6 weeks apart (index date defined as the first claim). The control cohort included patients without urticaria/angioedema claims (index date randomly assigned). Patients without at least 6 months of continuous Medicaid eligibility pre- and post-index were excluded. HRU and costs were compared between propensity score-matched cohorts during the post-index follow-up. RESULTS: A total of 548 CIU/CSU patients (mean [SD] age 4.5 [3.3] years; 51.3% male) were matched 1:1 with controls. In the CIU/CSU cohort, 51.8% used non-sedating prescription H(1)-antihistamines, 24.3% used oral corticosteroids, and 23.5% used other prescription H(1)-antihistamines; 13.5% consulted allergist/immunologists and 2.4% consulted dermatologists in the first 6 months of follow-up. Compared to controls, CIU/CSU patients had significantly more per patient per year (PPPY) inpatient (incidence rate ratio [IRR] 2.05), outpatient (IRR 2.20), and emergency department (IRR 1.64) visits (all p values < 0.05). Moreover, CIU/CSU patients also had significantly higher PPPY healthcare costs (mean cost difference [MCD] $1853), driven by incremental outpatient (MCD $1286) costs (all p values < 0.01). CONCLUSIONS: CIU/CSU pediatric patients had low use of non-sedating H(1)-antihistamines and high use of oral corticosteroids. Compared to CIU/CSU-free controls in the same age group, CIU/CSU pediatric patients had higher HRU and healthcare costs. FUNDING: Novartis Pharmaceuticals Corporation
format Online
Article
Text
id pubmed-5825330
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer Healthcare
record_format MEDLINE/PubMed
spelling pubmed-58253302018-02-28 Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States Williams, Paul V. Kavati, Abhishek Pilon, Dominic Xiao, Yongling Zhdanava, Maryia Balp, Maria-Magdalena Lefebvre, Patrick Ortiz, Benjamin Hernandez-Trujillo, Vivian Dermatol Ther (Heidelb) Original Research INTRODUCTION: Few studies have described chronic idiopathic/spontaneous urticaria (CIU/CSU) healthcare burden in adults, while this information remains largely unknown in children. We aimed to describe treatment patterns, healthcare resource utilization (HRU), and costs in CIU/CSU pediatric patients, as well as to compare HRU and costs in CIU/CSU and CIU/CSU-free pediatric patients. METHODS: Medicaid claims from four states (09/01/2013–03/31/2016) were used to identify patients less than 12 years old. The CIU/CSU cohort included patients with either at least two claims for idiopathic, other, or unspecified urticaria at least 6 weeks apart, or at least one claim for urticaria and at least one claim for angioedema at least 6 weeks apart (index date defined as the first claim). The control cohort included patients without urticaria/angioedema claims (index date randomly assigned). Patients without at least 6 months of continuous Medicaid eligibility pre- and post-index were excluded. HRU and costs were compared between propensity score-matched cohorts during the post-index follow-up. RESULTS: A total of 548 CIU/CSU patients (mean [SD] age 4.5 [3.3] years; 51.3% male) were matched 1:1 with controls. In the CIU/CSU cohort, 51.8% used non-sedating prescription H(1)-antihistamines, 24.3% used oral corticosteroids, and 23.5% used other prescription H(1)-antihistamines; 13.5% consulted allergist/immunologists and 2.4% consulted dermatologists in the first 6 months of follow-up. Compared to controls, CIU/CSU patients had significantly more per patient per year (PPPY) inpatient (incidence rate ratio [IRR] 2.05), outpatient (IRR 2.20), and emergency department (IRR 1.64) visits (all p values < 0.05). Moreover, CIU/CSU patients also had significantly higher PPPY healthcare costs (mean cost difference [MCD] $1853), driven by incremental outpatient (MCD $1286) costs (all p values < 0.01). CONCLUSIONS: CIU/CSU pediatric patients had low use of non-sedating H(1)-antihistamines and high use of oral corticosteroids. Compared to CIU/CSU-free controls in the same age group, CIU/CSU pediatric patients had higher HRU and healthcare costs. FUNDING: Novartis Pharmaceuticals Corporation Springer Healthcare 2018-02-10 /pmc/articles/PMC5825330/ /pubmed/29429043 http://dx.doi.org/10.1007/s13555-018-0225-6 Text en © The Author(s) 2018 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Williams, Paul V.
Kavati, Abhishek
Pilon, Dominic
Xiao, Yongling
Zhdanava, Maryia
Balp, Maria-Magdalena
Lefebvre, Patrick
Ortiz, Benjamin
Hernandez-Trujillo, Vivian
Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title_full Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title_fullStr Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title_full_unstemmed Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title_short Treatment Patterns, Healthcare Resource Utilization, and Spending Among Medicaid-Enrolled Children with Chronic Idiopathic/Spontaneous Urticaria in the United States
title_sort treatment patterns, healthcare resource utilization, and spending among medicaid-enrolled children with chronic idiopathic/spontaneous urticaria in the united states
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825330/
https://www.ncbi.nlm.nih.gov/pubmed/29429043
http://dx.doi.org/10.1007/s13555-018-0225-6
work_keys_str_mv AT williamspaulv treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT kavatiabhishek treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT pilondominic treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT xiaoyongling treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT zhdanavamaryia treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT balpmariamagdalena treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT lefebvrepatrick treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT ortizbenjamin treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates
AT hernandeztrujillovivian treatmentpatternshealthcareresourceutilizationandspendingamongmedicaidenrolledchildrenwithchronicidiopathicspontaneousurticariaintheunitedstates