AIMS: To quantify healthcare resource use (HCRU) and costs associated with varying levels of corticosteroid exposure. MATERIALS AND METHODS: Patients with a diagnosis of selected autoimmune and inflammatory diseases between 1 January 2006 and 30 September 2015 ("study period") were selected from a de-identified, privately-insured claims database. Patients were stratified into four treatment cohorts based on the dosing and duration of continuous corticosteroid use following disease diagnosis: intermittent use with <60 days of corticosteroid use and ≥60 days of corticosteroid use with low (≤7.5 mg/day), medium (>7.5-≤15 mg/day), or high (>15 mg/day) dosage. Patients were followed from the date of their highest dose episode of corticosteroid use ("treatment index date") until the earliest of the end of continuous corticosteroid use +30 days, disenrollment from health plan, or the end of the study period ("follow-up period"). HCRU and costs in the follow-up period were compared across treatment cohorts. RESULTS: Of 78,704 patients who were identified for study inclusion, 29% had extended corticosteroid use lasting ≥60 days, and 71% had intermittent use. On average, patients in the high-dose cohort incurred twice the cost of intermittent users ($68,408 vs $32,690 in annualized total all-cause healthcare costs, USD). Adverse event-related medical costs accounted for ∼40% of medical costs, and were higher than disease-related medical costs for all cohorts with extended corticosteroid exposure. Comparing the high-dose and low-dose cohorts, the smaller savings in disease-related prescriptions ($1,680) occurred along with a much larger cost in adverse event-related spend ($13,464). LIMITATIONS: The impact of corticosteroids may be under-estimated because of conservative follow-up duration, and administrative data may contain inaccuracies in coding. CONCLUSIONS: Steroid use, especially at higher doses, is associated with higher HCRU and costs.
AIMS: To quantify healthcare resource use (HCRU) and costs associated with varying levels of corticosteroid exposure. MATERIALS AND METHODS:Patients with a diagnosis of selected autoimmune and inflammatory diseases between 1 January 2006 and 30 September 2015 ("study period") were selected from a de-identified, privately-insured claims database. Patients were stratified into four treatment cohorts based on the dosing and duration of continuous corticosteroid use following disease diagnosis: intermittent use with <60 days of corticosteroid use and ≥60 days of corticosteroid use with low (≤7.5 mg/day), medium (>7.5-≤15 mg/day), or high (>15 mg/day) dosage. Patients were followed from the date of their highest dose episode of corticosteroid use ("treatment index date") until the earliest of the end of continuous corticosteroid use +30 days, disenrollment from health plan, or the end of the study period ("follow-up period"). HCRU and costs in the follow-up period were compared across treatment cohorts. RESULTS: Of 78,704 patients who were identified for study inclusion, 29% had extended corticosteroid use lasting ≥60 days, and 71% had intermittent use. On average, patients in the high-dose cohort incurred twice the cost of intermittent users ($68,408 vs $32,690 in annualized total all-cause healthcare costs, USD). Adverse event-related medical costs accounted for ∼40% of medical costs, and were higher than disease-related medical costs for all cohorts with extended corticosteroid exposure. Comparing the high-dose and low-dose cohorts, the smaller savings in disease-related prescriptions ($1,680) occurred along with a much larger cost in adverse event-related spend ($13,464). LIMITATIONS: The impact of corticosteroids may be under-estimated because of conservative follow-up duration, and administrative data may contain inaccuracies in coding. CONCLUSIONS:Steroid use, especially at higher doses, is associated with higher HCRU and costs.
Authors: Laura Bartels-Peculis; Ajay Sharma; Alison M Edwards; Anirudh Sanyal; Erin Connolly-Strong; Winnie W Nelson Journal: Open Access Rheumatol Date: 2020-06-22
Authors: Ishveen Chopra; Yimin Qin; John Kranyak; Jack R Gallagher; Kylee Heap; Susan Carroll; George J Wan Journal: Ther Adv Respir Dis Date: 2019 Jan-Dec Impact factor: 4.031
Authors: J Bradford Rice; Mary P Panaccio; Alan White; Mark Simes; Emma Billmyer; Nathaniel Downes; John Niewoehner; George J Wan Journal: Neurol Ther Date: 2020-11-10