Direct and indirect resource use, healthcare costs and work force absence in patients with non‐infectious intermediate, posterior or panuveitis

Abstract

PurposeTo ascertain resource use, costs and risk of workforce absence in non‐infectious uveitis cases versus matched controls.MethodsIn a retrospective claims analysis of employees in the United States, prevalent (N = 705) and incident (N = 776) cases 18–64 years old with ≥2 diagnoses of non‐infectious intermediate, posterior or panuveitis were matched 1:1 to controls without uveitis. Persistent prevalent cases (treated for ≥90 days, N = 112) also were analysed. Outcomes were annual direct resource use and costs associated with inpatient stays; emergency department, outpatient and ophthalmologist/optometrist visits; and prescription drugs. Indirect resource use and costs associated with work loss from disability and medically related absenteeism also were compared. Multivariate regression assessed cost differences between cases and controls.ResultsCases had significantly (p < 0.05) more medical resource use versus controls including 0.4 versus 0.2 emergency visits and 16.5 versus 7.6 outpatient/other visits. Cases used more prescription drugs (7.8 versus 4.1) and had more disability days (10.3 versus 4.6), medically related absenteeism days (8.5 versus 3.8), and work loss days (18.7 versus 8.4) than controls (all p < 0.05). Total direct ($12 940 versus $3730) and indirect ($3144 versus $1378) costs were higher in cases than controls (all p < 0.05). Results for persistent cases suggested greater utilization and associated cost and work loss burden. Compared with controls, cases had significantly greater risks of workforce absence, leave of absence and long‐term disability (all p < 0.05).ConclusionNon‐infectious intermediate, posterior or panuveitis, particularly persistent disease, is associated with substantial medical and work loss costs suggesting an unmet need for more effective treatments.

Doyne lecture 2016: intraocular health and the many faces of inflammation

“…30,31 The health-care burden is significant, where noninfectious uveitis accounts for substantial medical, social, and workload costs in the United Stated of America and aligns with data that persistent disease gives rise to considerable ocular and systemic morbidity. 24,[32][33][34] The clinical phenotype of non-infectious intraocular inflammation is replicated in experimental animal models that are driven by immune responses to self-antigen. 35 The animal models, such as experimental autoimmune uveoretinitis (EAU), support a role for autoimmunity with clinical-pathological features bearing remarkable similarity to man.…”

Katarakt bei Uveitis

“…Die Kataraktentwicklung ist bei chronischen und schweren Entzündungen besonders häufig. Das Kataraktrisiko steigt bei ausbleibender Reizfreiheit [7] und wird durch die Langzeitanwendung von höher dosierten topischen und/oder systemischen Kortikosteroiden gefördert. Eine kortikosteroidsparende Behandlung mit krankheitsmodifizierenden antirheumatischen Medikamenten (DMARDs) kann daher die Kataraktinzidenz reduzieren [7,8].…”

Improving eye care services with a lean approach

“…; Thorne et al. ). There is an imbalance between available healthcare resources and increasing demand of care for age‐related diseases (Tuulonen ).…”