Economic Burden of Non-Infectious Inflammatory Eye Disease (NIIED) in a Commercially-Insured Population in the United States

Albini, Thomas A.; Rice, J. Bradford; White, Alan G.; Johnson, Michaela E.; Reiff, Julie; Lima, Antonio Flavio; Bartels-Peculis, Laura; Ciepielewska, Gosia; Nelson, Winnie W.

doi:10.1080/09273948.2018.1560476

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Consistent with prior research, 12 the sample was limited to patients who had at least 1 potential index date with a relevant ICD-CM code in an inpatient setting or 2 potential index dates in an outpatient/ physician office setting separated by 30 days. Each patient's index date for the study was chosen at random from among their potential index dates, which allowed for patients at various disease stages (eg, as opposed to only those in early-stage) to be included.…”

Section: Sample Selectionmentioning

confidence: 99%

Predictors of High-cost Patients With Noninfectious Inflammatory Eye Diseases

Nelson

Rice

White

et al. 2019

Clinical Therapeutics

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Purpose: Noninfectious inflammatory eye diseases (NIIEDs), such as uveitis, is a general term used to describe a complex mix of acute, chronic, allergic, and inflammatory disorders. Prior literature has established that, in addition to severe clinical burden, NIIEDs is associated with significant economic burden for US payers; however, no literature provides a current estimate of the economic burden associated with patients with high-cost NIIEDs. This study aimed to better understand the cost and resource use distribution and predictors of patients with high-cost NIIEDs.Methods: This retrospective cohort study selected adult patients with NIIEDs from a large US administrative claims database between 2006 and 2015. Among the included patients, total all-cause health care costs were calculated for a randomly selected 12-month period. Patients in the top 20% of total all-cause health care costs were identified as high-cost patients; the remaining patients were identified as lower-cost patients. Patient demographic characteristics, clinical characteristics, cost, and health care resource utilization (HRU) were compared. Logistic regression models were used to determine characteristics associated with high-cost patients.Findings: Patients with NIIEDs (n ¼ 14,879) were categorized into 2976 high-cost and 11,903 lowercost patients. High-cost patients with NIIEDs were significantly more likely to experience blindness, cataract, cystoid macular degeneration, retinal detachment, and visual disturbances during the follow-up period than the lower-cost patients (all P < 0.05). The high-cost patients accounted for~7 7% of the total all-cause health care spend. Highcost patients incurred an average annual total health care cost of $59,873, and the top 1 percentile incurred $349,967 during the follow-up period. Hospitalization was a key cost driver among the high-cost patients, accounting for 50% of the total cost among the top 1 percentile of patients. High-cost patients were more likely to have specific autoimmune diseases, inpatient admission, and use of biologic and immunosuppressant agents.Implications: A small segment of patients with NIIEDs consumed most resources. This study identified several predictors based on patient characteristics and HRU that may help inform the profile of patients with NIIEDs with the highest health care needs. As such, patients with a given profile can be selected for targeted interventions by clinicians to potentially help improve quality of care and to reduce costs.

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Section: Sample Selectionmentioning

confidence: 99%

Predictors of High-cost Patients With Noninfectious Inflammatory Eye Diseases

Nelson

Rice

White

et al. 2019

Clinical Therapeutics

Self Cite

View full text Add to dashboard Cite

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“…The side effects of these medications can vary and require recurrent lab monitoring and long-term ophthalmic follow-up [3]. Adding together the healthcare expenses associated with the medications, phlebotomy, and recurrent office visits, the long term management of uveitis can carry a high cost [4][5][6]. This may effectively eliminate more expensive drugs as treatment options for financially constrained patient populations [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Adding together the healthcare expenses associated with the medications, phlebotomy, and recurrent office visits, the long term management of uveitis can carry a high cost [4][5][6]. This may effectively eliminate more expensive drugs as treatment options for financially constrained patient populations [4][5][6]. One study assessed this cost using a large administrative claims database in the United States [7].…”

Section: Introductionmentioning

confidence: 99%

Analyzing the demographics of patients with uveitis in an indigent, urban population

et al. 2023

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Purpose To study the types of uveitis examined in a hospital serving indigent populations in need of low-cost care. Methods A retrospective chart review examined the electronic medical records of all patients with uveitis-related at Drexel Eye Physicians. Data collected included demographics, anatomic location of the uveitis, systemic disease associations, treatment modalities and insurance. Statistical analysis was performed using χ² or Fischer exact tests. Results 270 patients (366 eyes) were included for analysis, 67% of patients identified as African American. Most eyes (95.3%, N = 349) were treated with topical corticosteroid drops, and only 6 (1.6%) received an intravitreal implant. Immunosuppressive medications were started in 24 patients (8.9%). Nearly 80% depended to some extent on Medicare or Medicaid Assistance for treatment coverage. There was no association between insurance type and use of biologics or difluprednate. Conclusion We found no association between insurance type and the prescription of medications for uveitis that should be used at home. There was a minimal number of patients prescribed medications for implantation in the office. The adherence of use of medications at home should be investigated.

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Epidemiology, clinical features, and classification of 3,404 patients with uveitis: Colombian Uveitis Multicenter Study (COL-UVEA)

de-la-Torre,

Mejía-Salgado,

Cifuentes-González

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose To describe the epidemiology, clinical features, and classification of uveitis in a large cohort of Colombian patients. Methods Data were collected from seven ophthalmological referral centers in the four main cities in Colombia. The study included patients with a confirmed diagnosis of uveitis from January 2010 to December 2022. Information on demographics, ophthalmic examination findings, uveitis classification, and etiology was recorded. Results The study reviewed 3,404 clinical records of patients with uveitis. The mean age at diagnosis was 41.1 (SD 19.0) years, and 54.2% of the patients were female. Overall, 1,341(39.4%) were infectious, 626 (18.4%) non-infectious, and four masquerade syndromes (0.1%). The most common types of uveitis were unilateral (66.7%), acute (48.3%), and non-granulomatous (83%). Anterior uveitis was the most common anatomical localization (49.5%), followed by posterior uveitis (22.9%), panuveitis (22.3%), and intermediate uveitis (5.2%). A diagnosis was established in 3,252 (95.5%) cases; idiopathic was the most common cause (27.7%), followed by toxoplasmosis (25.3%) and virus-associated uveitis (6.4%). The age group between 30 and 50 exhibited the highest frequency of uveitis. Conclusion This multicenter study comprehensively describes uveitis characteristics in Colombian patients, providing valuable insights into its demographic and clinical features. The study findings emphasize the need to continue updating the changing patterns of uveitis to improve diagnosis and treatment strategies for diseases associated with intraocular inflammation.

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Economic Burden of Non-Infectious Inflammatory Eye Disease (NIIED) in a Commercially-Insured Population in the United States

Cited by 4 publications

References 17 publications

Predictors of High-cost Patients With Noninfectious Inflammatory Eye Diseases

Predictors of High-cost Patients With Noninfectious Inflammatory Eye Diseases

Analyzing the demographics of patients with uveitis in an indigent, urban population

Epidemiology, clinical features, and classification of 3,404 patients with uveitis: Colombian Uveitis Multicenter Study (COL-UVEA)

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