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Treatment patterns and economic burden of sickle-cell disease patients prescribed hydroxyurea: a retrospective claims-based study.
Health Qual Life Outcomes. 2019 Oct 16; 17(1):155.HQ

Abstract

BACKGROUND

This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data.

METHODS

SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were analyzed descriptively.

RESULTS

A total of 3999 SCD patients prescribed HU were included; the mean age was 19.24 years, most patients were African American (73.3%), and the mean Charlson comorbidity index (CCI) score was 0.6. Asthma (20.3%), acute chest syndrome (15.6%), and infectious and parasitic diseases (20%) were the most prevalent comorbidities. During the 12-month follow-up period, 58.9% (N = 2357) of patients discontinued HU medication. The mean medication possession ratio (MPR) was 0.52, and 22.3% of patients had MPR ≥80%. The average length of stay (LOS) for SCD-related hospitalization was 13.35 days; 64% of patients had ≥1 SCD-related hospitalization. The mean annual total SCD-related costs per patient were $27,779, mostly inpatient costs ($20,128).

CONCLUSIONS

Overall, the study showed the patients had significant unmet needs manifest as poor medication adherence, high treatment discontinuation rates, and high economic burden.

Authors+Show Affiliations

Duke University, Durham, NC, USA.Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.STAinMED Research, Ann Arbor, MI, USA. lxie@citytech.cuny.edu. New York City College of Technology (CUNY), New York, NY, USA. lxie@citytech.cuny.edu.Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.New York City College of Technology (CUNY), New York, NY, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31619251

Citation

Shah, Nirmish, et al. "Treatment Patterns and Economic Burden of Sickle-cell Disease Patients Prescribed Hydroxyurea: a Retrospective Claims-based Study." Health and Quality of Life Outcomes, vol. 17, no. 1, 2019, p. 155.
Shah N, Bhor M, Xie L, et al. Treatment patterns and economic burden of sickle-cell disease patients prescribed hydroxyurea: a retrospective claims-based study. Health Qual Life Outcomes. 2019;17(1):155.
Shah, N., Bhor, M., Xie, L., Halloway, R., Arcona, S., Paulose, J., & Yuce, H. (2019). Treatment patterns and economic burden of sickle-cell disease patients prescribed hydroxyurea: a retrospective claims-based study. Health and Quality of Life Outcomes, 17(1), 155. https://doi.org/10.1186/s12955-019-1225-7
Shah N, et al. Treatment Patterns and Economic Burden of Sickle-cell Disease Patients Prescribed Hydroxyurea: a Retrospective Claims-based Study. Health Qual Life Outcomes. 2019 Oct 16;17(1):155. PubMed PMID: 31619251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment patterns and economic burden of sickle-cell disease patients prescribed hydroxyurea: a retrospective claims-based study. AU - Shah,Nirmish, AU - Bhor,Menaka, AU - Xie,Lin, AU - Halloway,Rashid, AU - Arcona,Steve, AU - Paulose,Jincy, AU - Yuce,Huseyin, Y1 - 2019/10/16/ PY - 2019/01/18/received PY - 2019/09/24/accepted PY - 2019/10/18/entrez PY - 2019/10/18/pubmed PY - 2020/1/15/medline KW - Adherence KW - Cost KW - Discontinuation KW - Health care KW - Hydroxyurea KW - Utilization SP - 155 EP - 155 JF - Health and quality of life outcomes JO - Health Qual Life Outcomes VL - 17 IS - 1 N2 - BACKGROUND: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data. METHODS: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were analyzed descriptively. RESULTS: A total of 3999 SCD patients prescribed HU were included; the mean age was 19.24 years, most patients were African American (73.3%), and the mean Charlson comorbidity index (CCI) score was 0.6. Asthma (20.3%), acute chest syndrome (15.6%), and infectious and parasitic diseases (20%) were the most prevalent comorbidities. During the 12-month follow-up period, 58.9% (N = 2357) of patients discontinued HU medication. The mean medication possession ratio (MPR) was 0.52, and 22.3% of patients had MPR ≥80%. The average length of stay (LOS) for SCD-related hospitalization was 13.35 days; 64% of patients had ≥1 SCD-related hospitalization. The mean annual total SCD-related costs per patient were $27,779, mostly inpatient costs ($20,128). CONCLUSIONS: Overall, the study showed the patients had significant unmet needs manifest as poor medication adherence, high treatment discontinuation rates, and high economic burden. SN - 1477-7525 UR - https://www.unboundmedicine.com/medline/citation/31619251/Treatment_patterns_and_economic_burden_of_sickle_cell_disease_patients_prescribed_hydroxyurea:_a_retrospective_claims_based_study_ L2 - https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1225-7 DB - PRIME DP - Unbound Medicine ER -