Cargando…

The financial and time burden associated with phenylketonuria treatment in the United States

BACKGROUND: Phenylketonuria (PKU) imposes a substantial burden on people living with the condition and their families. However, little is known about the time cost and financial burden of having PKU or caring for a child with the condition. METHODS AND FINDINGS: Primary data were collected with a de...

Descripción completa

Detalles Bibliográficos
Autores principales: Rose, Angela M., Grosse, Scott D., Garcia, Sandra P., Bach, Janice, Kleyn, Mary, Simon, Norma-Jean E., Prosser, Lisa A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6807265/
https://www.ncbi.nlm.nih.gov/pubmed/31660292
http://dx.doi.org/10.1016/j.ymgmr.2019.100523
_version_ 1783461695851593728
author Rose, Angela M.
Grosse, Scott D.
Garcia, Sandra P.
Bach, Janice
Kleyn, Mary
Simon, Norma-Jean E.
Prosser, Lisa A.
author_facet Rose, Angela M.
Grosse, Scott D.
Garcia, Sandra P.
Bach, Janice
Kleyn, Mary
Simon, Norma-Jean E.
Prosser, Lisa A.
author_sort Rose, Angela M.
collection PubMed
description BACKGROUND: Phenylketonuria (PKU) imposes a substantial burden on people living with the condition and their families. However, little is known about the time cost and financial burden of having PKU or caring for a child with the condition. METHODS AND FINDINGS: Primary data were collected with a detailed cost and utilization survey. Primary outcomes included utilization and out-of-pocket costs of medical services, medical formula, and prescribed low-protein food consumption, as well as the time and perceived effort involved in following the PKU diet. Respondents were people living with PKU or parents of children with PKU identified through a state newborn screening program database. Secondary administrative claims data were also used to calculate mean total, insurer, and out-of-pocket payments in inpatient, outpatient (office visits, emergency room, and laboratory tests), and pharmacy settings for privately insured persons with PKU. Payments were calculated for sapropterin and for PKU formula. In primary data analysis (children n = 32, adults n = 52), annual out-of-pocket costs were highest for low-protein foods (child = $1651; adult = $967) compared with other categories of care. The time burden of PKU care was high; families reported spending more than 300 h per year shopping for and preparing special diet foods. In secondary data analysis, children 12–17 years old had the highest average medical expenditures ($54,147; n = 140) compared to children 0–11 years old ($19,057; n = 396) and adults 18 years and older ($40,705; n = 454). Medication costs were the largest contributor to medical costs, accounting for 61–81% of total costs across age groups. Sapropterin was the largest driver of medication costs, accounting for 85% of child medication costs and 92% of adult medication costs. CONCLUSION: Treatment for PKU incurs a substantial time and cost burden on persons with PKU and their families. Estimated medical expenditures using claims data varied by age group, but sapropterin represented the largest cost for PKU treatment from a payer perspective across age groups.
format Online
Article
Text
id pubmed-6807265
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-68072652019-10-28 The financial and time burden associated with phenylketonuria treatment in the United States Rose, Angela M. Grosse, Scott D. Garcia, Sandra P. Bach, Janice Kleyn, Mary Simon, Norma-Jean E. Prosser, Lisa A. Mol Genet Metab Rep Research Paper BACKGROUND: Phenylketonuria (PKU) imposes a substantial burden on people living with the condition and their families. However, little is known about the time cost and financial burden of having PKU or caring for a child with the condition. METHODS AND FINDINGS: Primary data were collected with a detailed cost and utilization survey. Primary outcomes included utilization and out-of-pocket costs of medical services, medical formula, and prescribed low-protein food consumption, as well as the time and perceived effort involved in following the PKU diet. Respondents were people living with PKU or parents of children with PKU identified through a state newborn screening program database. Secondary administrative claims data were also used to calculate mean total, insurer, and out-of-pocket payments in inpatient, outpatient (office visits, emergency room, and laboratory tests), and pharmacy settings for privately insured persons with PKU. Payments were calculated for sapropterin and for PKU formula. In primary data analysis (children n = 32, adults n = 52), annual out-of-pocket costs were highest for low-protein foods (child = $1651; adult = $967) compared with other categories of care. The time burden of PKU care was high; families reported spending more than 300 h per year shopping for and preparing special diet foods. In secondary data analysis, children 12–17 years old had the highest average medical expenditures ($54,147; n = 140) compared to children 0–11 years old ($19,057; n = 396) and adults 18 years and older ($40,705; n = 454). Medication costs were the largest contributor to medical costs, accounting for 61–81% of total costs across age groups. Sapropterin was the largest driver of medication costs, accounting for 85% of child medication costs and 92% of adult medication costs. CONCLUSION: Treatment for PKU incurs a substantial time and cost burden on persons with PKU and their families. Estimated medical expenditures using claims data varied by age group, but sapropterin represented the largest cost for PKU treatment from a payer perspective across age groups. Elsevier 2019-10-16 /pmc/articles/PMC6807265/ /pubmed/31660292 http://dx.doi.org/10.1016/j.ymgmr.2019.100523 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Rose, Angela M.
Grosse, Scott D.
Garcia, Sandra P.
Bach, Janice
Kleyn, Mary
Simon, Norma-Jean E.
Prosser, Lisa A.
The financial and time burden associated with phenylketonuria treatment in the United States
title The financial and time burden associated with phenylketonuria treatment in the United States
title_full The financial and time burden associated with phenylketonuria treatment in the United States
title_fullStr The financial and time burden associated with phenylketonuria treatment in the United States
title_full_unstemmed The financial and time burden associated with phenylketonuria treatment in the United States
title_short The financial and time burden associated with phenylketonuria treatment in the United States
title_sort financial and time burden associated with phenylketonuria treatment in the united states
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6807265/
https://www.ncbi.nlm.nih.gov/pubmed/31660292
http://dx.doi.org/10.1016/j.ymgmr.2019.100523
work_keys_str_mv AT roseangelam thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT grossescottd thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT garciasandrap thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT bachjanice thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT kleynmary thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT simonnormajeane thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT prosserlisaa thefinancialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT roseangelam financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT grossescottd financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT garciasandrap financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT bachjanice financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT kleynmary financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT simonnormajeane financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates
AT prosserlisaa financialandtimeburdenassociatedwithphenylketonuriatreatmentintheunitedstates