Burden of Illness for Adults Living With Primary Chronic Immune Thrombocytopenia in the United States

OBJECTIVES: Primary immune thrombocytopenia (ITP), a rare autoimmune platelet disorder, presents a multifaceted challenge owing to its diverse treatment approaches. The objective of this study was to assess healthcare resource utilization (HCRU) and cost among adults with primary chronic ITP in the United States (US), and any disparities observed based on their treatment strategies.

METHODS: Utilizing a comprehensive US-based administrative claims database (Komodo Health closed claims, January 2015-March 2023), adults aged ≥18 years with primary chronic ITP were identified as follows: (1) ≥2 outpatient (30-365 days apart) or ≥1 inpatient claim(s) associated with primary ITP between Jan 2016 and Mar 2021, (2) ≥3 years of continuous enrollment with no ITP diagnoses 1 year pre-first primary ITP claim, (3) absence of diagnostic/treatment codes associated with secondary ITP, and (4) ≥1 primary ITP claim during the chronic phase (365-730 days following their first diagnosis). Mean all-cause and ITP-related HCRU and costs in the chronic phase were evaluated on a per-patient per-year basis.

RESULTS: Among 7576 patients identified, mean HCRU and costs in the chronic phase were substantial (outpatient visits: 3.45 visits, inpatient hospitalizations: 0.11 events, length of stay: 4.61 days, all-cause costs: $20,625, direct costs for ITP treatments: $8,838). All-cause costs were nearly 4-fold greater for patients receiving chronic ITP treatment versus those who were not treated ($34,293 [n=3499] vs. $8,895 [n=4077]). For a subset continuously treated with thrombopoietin receptor agonists (TPOs, n=259, 3.4%), mean outpatient visits were 5.4-fold higher (18.75 visits) and all-cause costs were 7.9-fold higher ($162,253) compared with the overall cohort.

CONCLUSIONS: Substantial unmet need reflected by high HCRU and costs was identified in primary chronic ITP, which was markedly pronounced for those continuously treated with TPOs. This highlights the imperative need for targeted interventions that can reduce HCRU burden and costs associated with primary chronic ITP.