Healthcare resource utilization and work loss in dermatomyositis and polymyositis patients in a privately-insured US population

Abstract

Background Dermatomyositis and polymyositis (DM/PM) are inflammatory myopathies characterized by muscle inflammation/weakness. Patients with DM/PM have a reduced quality-of-life and are at an increased risk for several comorbidities. Studies have assessed the incidence and prevalence of DM/PM; however, no study has estimated the burden of the diseases in terms of both healthcare resource utilization (HCRU) and work loss incurred by patients. Objective To provide a comprehensive, current estimate of the annual HCRU and work loss in DM/PM patients in the US. Methods All patients (aged 18-64 years) with a first diagnosis of DM/PM between January 1, 1998 and March 31, 2014 ('index date') were selected from a de-identified privately-insured administrative claims database. DM/PM patients were required to have continuous health-plan enrollment 12 months prior to and following their index date. Propensity-score (1:1) matching of DM/PM patients with non-DM/PM controls was carried out based on a logistic regression of demographic characteristics, comorbidities, costs, and HCRU to control for these confounding factors. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched DM/PM and the non-DM/PM cohorts over the 12-month period after the index date ('outcome period'). Results Of the 2617 DM/PM patients that met sample selection criteria, 2587 (98.9%) were matched with a non-DM/PM control. During the outcome period, DM/PM patients had significantly increased HCRU across places of service, including 44% more inpatient admissions (3.6 vs 2.5, p < 0.001), increased visits with specialists such as rheumatologists, neurologists and physical therapists, and filled 4.7 more prescriptions (32.2 vs 27.5, p < 0.001) than matched control patients. The increased HCRU led to significantly more medically-related work loss among DM/PM patients than matched controls (p < 0.001). Conclusions DM/PM imposes a substantial increase in healthcare resource use and is associated with statistically significantly greater work loss in the first year following diagnosis.

Health‐related quality of life and work impairment in idiopathic inflammatory myopathies in South Australia

“…Progressive muscle weakness and organ involvement can adversely affect health‐related quality of life (HRQOL) and work productivity (WP) 3‐8 …”

“…Data and literature on the effects of IIM on WP have also not been extensively studied to date, with some literature suggesting that there are impacts 5‐7 . Herein we examined the impact of IIM on HRQOL and WP in a group of South Australian patients.…”

Medical resource utilization in dermatomyositis/polymyositis patients treated with repository corticotropin injection, intravenous immunoglobulin, and/or rituximab

“…DM/PM can be associated with increased medical resource use (MRU) and productivity loss 3. These two diseases are often grouped together due to their shared clinical features; however, DM can also be associated with skin rash on the hands, feet, elbows, face, and/or upper body 1,4.…”

Hospitalizations due to systemic connective tissue diseases: Secular trends and regional disparities in Sweden, 1998‐2016

“…The systemic connective tissue diseases (SCTD) including systemic vasculitis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren syndrome, polymyositis and dermatomyositis are a group of chronic inflammatory systemic autoimmune disorders associated with disability, pain, deterioration in quality of life, morbidity and excess mortality . These disorders are also associated with substantial health care costs and productivity losses (work disability, early retirement) imposing significant economic burden on patients, healthcare systems and societies . For instance, there was a 3‐fold difference in total costs for SLE in an incipient cohort compared with matched population controls in southern Sweden .…”