Estimating the Cost of Illness of Giant Cell Arteritis in the United States

Babigumira, Joseph B.; Li, Meng; Boudreau, Denise M.; Best, Jennie H.; Garrison, Louis P.

doi:10.1007/s40744-017-0052-8

Cited by 13 publications

(12 citation statements)

References 34 publications

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“…To our knowledge, no other study has evaluated utilization or cost in the time period leading up to the GCA incidence date. A recent database study by Babigumira and colleagues used a national sample of U.S. administrative medical claims to estimate the cost-of-illness of GCA limited to the year immediately following diagnosis[21]. Similar to the current study, Babigumira et al found one-year cost was significantly increased among patients with GCA.…”

Section: Discussionsupporting

confidence: 71%

“…One study evaluated the socioeconomic impact of five systemic vasculitides including GCA in New York State using hospital admission data sources[19]. However, only costs attributed to inpatient care were reported, and a population-based comparator cohort was not included for incremental cost assessment[21]. While a marginally greater risk of hospitalization has already been previously described in our cohort[20], our study did not identify a noticeable significant difference in the overall cost of inpatient care between subjects with GCA and non-GCA referent subjects.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Healthcare Use and Direct Cost of Giant Cell Arteritis: A Population-based Study

Koster

Achenbach²,

Crowson

et al. 2017

J Rheumatol

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Objective To determine the healthcare utilization and direct medical cost of giant cell arteritis (GCA) in a population-based cohort. Methods A well-defined, retrospective population-based cohort of Olmsted County, Minnesota residents diagnosed with GCA from 1982–2009 was compared to a matched referent cohort from the same population. Standardized cost data (inflation-adjusted to 2014 dollars) for 1987–2014 and outpatient utilization data for 1995–2014 were obtained. Utilization and costs were compared between cohorts using signed rank paired tests, McNemar’s tests, and quantile regression models. Results Significant annual differences in outpatient cost were observed for patients with GCA in each of the first four years (median differences: $2085, $437, $382, $388, respectively). In adjusted analyses, median incremental cost attributed to GCA over a 5-year period was $4662. Compared to matched referent subjects, patients with GCA had higher utilization of laboratory visit-days annually for each of the first 3 years following incidence/index date, and increased outpatient physician visits for years 0–1, 1–2, and 3–4 years. Patients with GCA had significantly more radiology visit-days in years 0–1, 3–4, and 4–5 and more ophthalmologic procedures/surgery in years 0–1, 1–2, 2–3, and 4–5 compared to non-GCA. Emergency medicine visits, musculoskeletal and cardiovascular procedures/surgery were similar between GCA and non-GCA groups throughout the study period. Conclusions Direct medical outpatient costs were increased in the month preceding and in the first 4 years following GCA diagnosis. Higher utilization of outpatient physician, laboratory and radiology visits, and ophthalmologic procedures among these patients accounts for the increased cost of care.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Healthcare Use and Direct Cost of Giant Cell Arteritis: A Population-based Study

Koster

Achenbach²,

Crowson

et al. 2017

J Rheumatol

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show abstract

“…A 2017 study also using US healthcare claims data demonstrated that in the year following diagnosis, estimated total healthcare costs were USD $16,431 more in patients with GCA than in patients without GCA. 16 Notably, the estimated increase in pharmacy costs in patients with GCA compared with controls during the first year after diagnosis was only USD $663; this was likely because steroids, the mainstay of treatment for GCA, are relatively inexpensive. However, our current study suggests that steroids can have a substantial effect on costs for patients with GCA, as higher cumulative OGC dose was associated with increased AEs and AE-related healthcare costs.…”

Section: Discussionmentioning

confidence: 99%

“…A prior healthcare cost analysis reported that patients with GCA experience substantially higher healthcare costs (> USD $16,000 more) in the first year following diagnosis than patients without GCA. 16 GCA was identified as a major contributor to the USD $150 million in annual hospitalization costs associated with vasculitis in the United States. 17 A model-based study projected that from 2015 to 2050, the estimated costs associated with GCA-related visual impairments and steroid-induced fractures will reach USD $76 billion and USD $6 billion, respectively.…”

Section: Introductionmentioning

confidence: 99%

<p>Healthcare Costs of Potential Glucocorticoid-Associated Adverse Events in Patients with Giant Cell Arteritis</p>

Best¹,

Kong

Smith

et al. 2019

CEOR

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Objective: To quantify the healthcare expenditures associated with potential oral glucocorticoid (OGC)-related adverse events (AEs) in patients with giant cell arteritis (GCA). Methods: Patients with GCA and ≥ 1 OGC prescription fill between 2009 and 2014 were identified from the MarketScan Commercial and Medicare Supplemental claims databases. Patients were stratified into four groups based on cumulative OGC dose (> 0 to ≤ 2607 mg, > 2607 to ≤ 4800 mg, > 4800 to ≤ 7200 mg, and > 7200 mg) during the 1-year follow-up period; incidence of potential AEs and AE-related direct healthcare costs in USD were assessed. Association between the log of cumulative OGC dose and AE-related direct healthcare costs was evaluated, adjusting for baseline characteristics. Results: Of 1602 patients with GCA included, 69% were women; the mean age was 73 years. The mean cumulative OGC dose was 5806 mg during the 1-year follow-up; most exposure occurred in the first 6 months. The proportion of patients with potential OGC-related AEs was 36.5% overall and increased as cumulative dose increased (30.7%-45.3% across dose groups). Unadjusted mean AE-related costs for patients with an AE was USD $12,818. In the multivariable model including all patients, increasing OGC dose was associated with increasing AE-related healthcare costs (cost ratio, 1.38 [95% CI, 1.16-1.64] per 1-unit increase in log of cumulative OGC dose [P < 0.001]). Mean (median)-predicted AE costs for the dose groups were USD $4389 ($2749) for > 0 to ≤ 2607 mg, USD $5176 ($3009) for > 2607 to ≤ 4800 mg, USD $5576 ($3633) for > 4800 to ≤ 7200 mg, and USD $6609 ($4447) for > 7200 mg. Conclusion:In patients with GCA, OGC-related AEs increased with increasing cumulative OGC dose, resulting in increased healthcare costs. These results highlight the need for efficacious therapies that reduce the exposure to and potential risks associated with OGCs.

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“…According to the Cotch study , GCA led to hospital costs of $355.4 million nationwide for an estimated 56,619 hospital admissions, based on New York State hospitalization data and extrapolating to the US. A recent study from Babigumira et al has estimated the COI of GCA in the US during the year after GCA diagnosis . They estimated the mean incremental cost between GCA patients and controls, from a national sample of administrative medical claims, to more than $15,000.…”

Section: Discussionmentioning

confidence: 99%