Direct costs of carcinoid syndrome diarrhea among adults in the United States

Abstract

BACKGROUNDThe burden of carcinoid syndrome (CS) among patients with neuroendocrine tumors is substantial and has been shown to result in increased healthcare resource use and costs. The incremental burden of CS diarrhea (CSD) is less well understood, particularly among working age adults who make up a large proportion of the population of patients with CS.AIMTo estimate the direct medical costs of CSD to a self-insured employer in the United States.METHODSCS patients with and without CSD were identified in the IBM® MarketScan® Database, including the Medicare Supplemental Coordination of Benefits database. Eligible patients had ≥ 1 medical claim for CS with continuous health plan enrollment for ≥ 12 mo prior to their first CS diagnosis and for ≥ 30 d after, no claims for acromegaly, and no clinical trial participation during the study period (2014-2016). Baseline demographic and clinical characteristics, including comorbidities and treatment, were analyzed using descriptive statistics. Measures of healthcare resource use and costs were compared between patients with and without CSD, including Emergency Department (ED) visits, hospital admissions and length of stay, physician office visits, outpatient services, and prescription claims, using univariate and multivariate analyses to evaluate associations of CSD with healthcare resource use and costs, controlling for baseline characteristics.RESULTSOverall, 6855 patients with CS were identified of which 4,043 were eligible for the analysis (1352 with CSD, 2691 with CS only). Baseline demographic and clinical characteristics were similar between groups with the exception of age, underlying tumor type, and health insurance plan. Patients with CSD were older, had more comorbidities, and received more somatostatin analog therapy at baseline. Patients with CSD required greater use of healthcare resources and incurred higher costs than their peers without CSD, including hospitalizations (44% vs 25%) and ED visits (55% vs 31%). The total adjusted annual healthcare costs per patient were 50% higher (+ $23865) among those with CSD, driven by outpatient services (+ 56%), prescriptions (+ 48%), ED visits (+ 26%), physician office visits (+ 21%), and hospital admissions (+ 11%).CONCLUSIONThe economic burden of CSD is greater than that of CS alone among insured working age adults in the United States, which may benefit from timely diagnosis and management.

Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome

“…This study also indicated that patients with recurrent disease suffered from significant fatigue, and impaired sleep and physical functioning. Another study indicated that the economic burden of CS was 50% higher among patients with diarrhea, than that of CS with another symptom among insured working age adults in the United States 87 …”

“…Another study indicated that the economic burden of CS was 50% higher among patients with diarrhea, than that of CS with another symptom among insured working age adults in the United States. 87 Patients with CS have different symptoms, treatment side effects, and emotional and functional concerns compared to patients with other neoplastic diseases. A recent study aimed to identify the highest priority symptoms and concerns of patients with CS by developing the Functional Assessment of Cancer Therapy-Carcinoid Syndrome Symptom Index.…”

The role of serotonin inhibition within the treatment of carcinoid syndrome

“…The total adjusted annual healthcare cost per patient was 50% higher among those with carcinoid syndrome diarrhoea, mainly driven by outpatient services, prescriptions and ED visits. (Dasari et al, 2019) CS negatively impacts the patient and the healthcare system. Timely identification and management of carcinoid syndrome and CS related diarrhoea may reduce the economic burden.…”

Changes in Carcinoid Syndrome Symptoms Among Patients Receiving Telotristat Ethyl in US Clinical Practice: Findings from the TELEPRO-II Real-World Study

“… 6 CS diarrhea and flushing are the most common and disruptive symptoms of CS, with CS diarrhea having a substantial negative impact on quality of life. 2 Patients with CS diarrhea are hospitalized more often and incur higher overall healthcare costs than those without CSD, 7 , 8 and experience impairment in work productivity and indirect costs, 9 reinforcing the need for more effective management of CS.…”