Michael S Broder1, Maureen P Neary2, Eunice Chang3, William H Ludlam2. 1. Partnership for Health Analytic Research, LLC, 280 South Beverly Drive, Suite 404, Beverly Hills, CA, 90212, USA. mbroder@pharllc.com. 2. Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA. 3. Partnership for Health Analytic Research, LLC, 280 South Beverly Drive, Suite 404, Beverly Hills, CA, 90212, USA.
Abstract
PURPOSE: Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. METHODS: Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. RESULTS: There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001). CONCLUSIONS: CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.
PURPOSE: Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CDpatients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. METHODS: Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CDpatients; (2) DMpatients; and (3) population-based control patients without CD. DM and control patients were matched to CDpatients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. RESULTS: There were 1852 CDpatients, 3704 DMpatients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CDpatients were hospitalized more frequently (19.3 %) than DMpatients (11.0 %, p < .001) or controls (5.6 %, p < .001). CDpatients visited the ED more frequently (25.4 %) than DMpatients (21.1 %, p < .001) or controls (14.3 %, p < .001). CDpatients had more office visits than DMpatients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CDpatients on average filled more prescriptions than DMpatients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CDpatients were $26,269 versus $12,282 for DMpatients (p < .001) and $5869 for controls (p < .001). CONCLUSIONS:CDpatients had significantly higher annual rates of healthcare resource utilization compared to matched DMpatients and population controls without CD. CDpatient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.
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