Organ damage leads to a surge in the economic cost of sickle cell disease

Patient’s end-stage organ injury (EOD) Sickle cell disease According to a new study, (SCD) constitutes a significant financial burden in the United States through both direct health care costs and indirect downstream economic benefits.

the study, Published on Journal of Managed Care & Specialty PharmacyIs the first company to focus specifically on costs associated with EOD, a category of complications including conditions such as stroke, chronic kidney disease (CKD), end-stage renal disease (ESRD), and pulmonary hypertension (PH). It is one.

The study is based on claims from the MarketScan Medicaid claims database and has identified 10,784 SCD patients. The average age of the patients was 18.5 years and the pool of patients was 54.5% female.

The authors of the study used the earliest SCD diagnosis as the patient index date and followed those patients at 3-month “intervals.” The result was approximately 152,455 3-month patient intervals, with EOD reported in 12% of these intervals. Compared to patients without EOD, patients with EOD spend more days in hospitals, more visits to emergency departments and outpatients, more laboratory tests, and outpatient pharmacy claims. Due to the large number of patients, medical expenses were incurred due to significantly higher costs.

Medical costs for SCD patients suffering from stores are 4.68 times higher than those without EOD in the first year after a stroke, and more than double the cost of patients without EOD one year after the stroke. It took. Patients with ESRD had a 3.4-fold increase in health care costs compared to patients without EOD. Patients with CKD and PH cost twice as much as non-EOD patients.

These costs were converted into costs well over $ 250,000 each for the first year after stroke ($ 285,816) and an average of $ 127,393 per year, and within the first year and after the first year of stroke. The average annual cost for SCD patients with CKD ($ 135,493), ESRD ($ 209,172), and PH ($ 148,174) was all six digits.

In terms of health care use, patients with EOD received health care services on average 56-62 days a year, while patients with SCD who did not experience EOD took 21-25 days.

Corresponding authors Ze Cong, PhD, and colleagues at Global Blood Therapeutics write that such medical costs are only part of the financial burden of SCD. Reduced productivity is another important economic aspect of the disease. They pointed out that a previous study found that nearly half of adults with SCD were unable to work due to the burden of disease management or the severity of their symptoms.

In this study, the Medicaid database did not contain the data needed to calculate absenteeism, so Cong and colleagues used medical days as a substitute for absenteeism. As mentioned above, patients with EOD received more than twice as many days of medical service as patients without EOD.

“Future studies need to collect productivity loss data for SCD patients and make efforts to accurately quantify the impact of SCD on society beyond the healthcare system,” they wrote.

The authors conclude that their study reveals that while SCD itself puts a heavy financial burden on patients and the wider economy, those burdens increase significantly when patients subsequently suffer from EOD. I did.

“SCD management strategies that can potentially reduce the risk of EOD provide clinical and economic value to patients and society,” they said.

reference

Economic Burden of Terminal Organ Injury in Medicaid Patients with Sickle Cell Disease in the United States, such as Campbell A, Kong Z, and Agodore I: Population-based Longitudinal Claims Study. J Manag Care Spec Pharm.. 2020; 26 (9): 1121-1129. Doi: 10.18553 / jmcp.2020.20009