Healthcare resource utilization and costs by disease severity in an insured national sample of US patients with chronic hepatitis B

Nguyen, Mindie H.; Ozbay, A. Burak; Liou, Iris; Meyer, Nicole; Gordon, Stuart C.; Dusheiko, Geoffrey; Lim, Joseph K.

doi:10.1016/j.jhep.2018.09.021

Cited by 40 publications

(31 citation statements)

References 15 publications

(17 reference statements)

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“…for over 240 million de-identified patients in the US with Commercial and Medicare Supplemental insurance. The MarketScan database is commonly used for health economic studies of healthcare resource utilization and expenditures in insured populations including rare disease population such as patients with acute porphyria 9,21,22 .…”

Section: Datamentioning

confidence: 99%

Real-world annualized healthcare utilization and expenditures among insured US patients with acute intermittent porphyria (AIP) treated with hemin

Blaylock¹,

Jb²,

Stickler³

2020

Journal of Medical Economics

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Background and aims: Patients with acute intermittent porphyria (AIP) may suffer from acute nonspecific attacks that often result in hospitalizations or emergency room (ER) visits. Prior to the recent approval of givosiran (November 2019), hemin was the only FDA-approved therapy for AIP attacks in the US. Our aim was to estimate the annual healthcare utilization and expenditures for AIP patients treated with hemin using real-world data. Methods: Patients with !1 hemin claim and confirmed AIP diagnosis -1 inpatient claim or 2 outpatient claims !30 d apart for AIP (2015)(2016)(2017) or acute porphyria (prior to 2015)were identified in MarketScan administrative claims dataset between 2007 and 2017. Continuous enrolment for !6 months from confirmed diagnosis was required. A secondary analysis ("active disease population") limited the sample to adult patients with !3 attacks or 10 months of prophylactic use of hemin within a 12-month pre-index period. AIP-related care was defined by hemin use during an attack (daily glucose and/or hemin use) or prophylaxis (non-attack hemin use). Outcomes were annualized and expenditures were inflated to 2017. Results: Across 10 years, patients with a confirmed AIP diagnosis (N ¼ 8,877) and !1 hemin claim (N ¼ 164) were restricted by !6 months continuous follow-up (N ¼ 139). AIP patients were mostly female (N ¼ 112; 81%), had median age of 40 and 3 years average follow-up. Annualized average total expenditures for AIP-related care were $113,477. Annualized average all-cause (any diagnosis) hospitalizations were statistically significantly lower for patients treated with hemin prophylaxis vs. acute treatment (1.0 vs. 2.1; p < .001). In the secondary analysis (N ¼ 27), annualized average total expenditures for AIP-related care were higher ($187,480). Conclusions: For AIP patients treated with hemin, patients treated for acute attacks may use a greater number of resources compared to patients treated prophylactically.

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Section: Datamentioning

confidence: 99%

Real-world annualized healthcare utilization and expenditures among insured US patients with acute intermittent porphyria (AIP) treated with hemin

Blaylock¹,

Jb²,

Stickler³

2020

Journal of Medical Economics

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“…Currently, there is no cure for CHB, so the emphasis of management is on prevention through vaccination. In fact, since 1991, when the United States adopted childhood vaccination programs, there has been a 68% decrease in the prevalence of HBV infection …”

Section: Adverse Effects Of Antiviral Therapymentioning

confidence: 99%

“…The annual incidence rate of cirrhosis among those with CHB is 1% to 2%, whereas among those with cirrhosis, the annual incidence rate of hepatocellular carcinoma is 3% to 5% . In addition to the high clinical burden with disease progression for those with CHB, there is also higher health care cost and resource utilization …”

mentioning

confidence: 99%

“…In fact, since 1991, when the United States adopted childhood vaccination programs, there has been a 68% decrease in the prevalence of HBV infection. 4,30,31 However, for those with CHB, viral suppression is the goal of therapy. 32,33 Among first-line therapies, entecavir (ETV) was introduced in 2005, followed by tenofovir disoproxil fumarate (TDF) in 2008 and tenofovir alafenamide (TAF) in 2016.…”

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confidence: 99%

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Nonliver Comorbidities in Patients With Chronic Hepatitis B

Wei

Henry

Nguyen

2019

Clinical Liver Disease

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“…It might also be attributed to limited resources as well as increased cost of healthcare. Healthcare resource utilization and costs by different diseases shows a high economic burden highlighting need for taking some actions for decreasing costs [45][46][47]. The results of this review showed that CDSSs have the ability to improve laboratory tests utilization in some cases including hepatitis B virus, Clostridium Di cile, magnesium, B-Type natriuric peptide, TFT, ESR, and heparin-induced thrombocytopenia tests.…”

Section: Discussionmentioning

confidence: 91%

Laboratory Test Ordering in Inpatient Hospitals: A Scoping Review on the Effects and Features of Clinical Decision Support Systems

Zare

Meidani

Shirdeli

et al. 2020

Preprint

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Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review was aimed to evaluate the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes were categorized based on test-related, physician-related, and patient-related. The primary outcome measures were the number and cost of laboratory test ordered.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

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Healthcare resource utilization and costs by disease severity in an insured national sample of US patients with chronic hepatitis B

Cited by 40 publications

References 15 publications

Real-world annualized healthcare utilization and expenditures among insured US patients with acute intermittent porphyria (AIP) treated with hemin

Real-world annualized healthcare utilization and expenditures among insured US patients with acute intermittent porphyria (AIP) treated with hemin

Nonliver Comorbidities in Patients With Chronic Hepatitis B

Laboratory Test Ordering in Inpatient Hospitals: A Scoping Review on the Effects and Features of Clinical Decision Support Systems

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