Healthcare Resource Utilization Among Patients with Sickle Cell Disease with Recurrent Vaso-Occlusive Crises in France

OBJECTIVES: Sickle cell disease (SCD) is an inherited hemoglobinopathy that can lead to vaso-occlusive crises (VOCs) and significant morbidity despite the availability of current treatment options. This study describes the healthcare resource utilization (HCRU) of patients with SCD with recurrent VOCs in France.

METHODS: This longitudinal, retrospective cohort study utilized the French National Health Data System database (SNDS, système national des données de santé). Patients were identified by having an inpatient claim or registration in the long-term condition database (ALD, affection longue durée) with a diagnosis of SCD between January 1, 2012, and March 1, 2019. Eligible patients with SCD were required to have ≥2 VOCs/year in any 2 consecutive years. Patients were required to have ≥1 year of data before and after their index date (i.e., the second VOC in the second consecutive year). Patients were followed from index until death or study period end (March 1, 2020). Demographics were assessed at index. The rates of VOCs and HCRU were summarized per patient per year (PPPY) during the follow-up period.

RESULTS: A total of 4,602 patients with SCD with recurrent VOCs were included. The mean age of patients was 19.8 years, and 2,384 (51.8%) patients were female. Mean length of follow-up was 4.4 years. Patients averaged 3.8 VOCs PPPY during the follow-up period. Patients averaged 5.7 inpatient hospital admissions PPPY; of these, 2.9 were day cases and 2.9 were overnight stays lasting ≥1 day. Patients also averaged 6.0 emergency room visits, 6.6 outpatient visits, and 13.4 outpatient prescriptions (all PPPY).

CONCLUSIONS: There is substantial HCRU associated with the care of patients with SCD with recurrent VOCs in France, driven by frequent inpatient hospitalizations, including those for VOCs, emergency room visits, outpatient visits, and prescriptions.