Economic Burden of Managing Vaso-Occlusive Crisis Among Patients With Sickle Cell Disease in the United States: A Systematic Review
Author(s)
Aishat K. Ghazali, B.Pharm.1, Hyeun Ah KANG, MEd, MS, RPh, PhD2, Pin Hsuan Liao, B.Pharm.1, Ayobami A. Aiyeolemi, B.Pharm.1;
1The University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2The University of Texas at Austin, Health Outcomes Division,College of Pharmacy, Austin, TX, USA
1The University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2The University of Texas at Austin, Health Outcomes Division,College of Pharmacy, Austin, TX, USA
Presentation Documents
OBJECTIVES: Vaso-occlusive crisis (VOC) is the hallmark symptom of sickle cell disease (SCD) and is a significant driver of healthcare utilization among individuals with SCD. However, the costs of managing VOCs remain unclear. This systematic review aims to synthesize literature that measured the direct economic burden of managing VOCs in patients with SCD in the U.S.
METHODS: A systematic review evaluated the economic burden of managing VOCs in SCD patients. Seven electronic databases were searched: PubMed, CINAHL, Web of Science, PsycINFO, EconLit, ScienceDirect, and Embase, using terms like sickle cell disease, vaso-occlusive crises, and economic burden. Studies reporting U.S.-based VOC-related costs were included, and data on costs, study period, and datasets were extracted to provide an overview of the economic impact of VOC management in SCD. Costs were adjusted to the 2024 inflation rate using the Consumer Price Index (CPI).
RESULTS: Six retrospective U.S. studies out of 398 studies reported direct VOC costs using databases like MarketScan, Medicaid, and Kids Inpatient Database. VOC costs were reported by care setting, insurance, hydroxyurea adherence, and opioid use disorders. Inpatient costs were the highest, followed by emergency and outpatient settings. Adjusted to the 2024 inflation rate, annual VOC hospitalization costs totaled $808.86 million, and median hospital charges ranged from $16,730.83 to $21,389.78. Medicaid inpatient costs were $30,378.70, 16.0% higher than commercial ($26,182.30) and 6.9% higher than Medicare ($28,422.48). VOC-related hospitalization costs for patients with opioid use disorder were 13.2% higher than those without. Non-adherent hydroxyurea patients had 65.2% higher VOC costs than adherent patients.
CONCLUSIONS: Managing VOCs in SCD patients imposes a significant economic burden, with costs varying based on type of medical service, presence of comorbid conditions, and treatment adherence
METHODS: A systematic review evaluated the economic burden of managing VOCs in SCD patients. Seven electronic databases were searched: PubMed, CINAHL, Web of Science, PsycINFO, EconLit, ScienceDirect, and Embase, using terms like sickle cell disease, vaso-occlusive crises, and economic burden. Studies reporting U.S.-based VOC-related costs were included, and data on costs, study period, and datasets were extracted to provide an overview of the economic impact of VOC management in SCD. Costs were adjusted to the 2024 inflation rate using the Consumer Price Index (CPI).
RESULTS: Six retrospective U.S. studies out of 398 studies reported direct VOC costs using databases like MarketScan, Medicaid, and Kids Inpatient Database. VOC costs were reported by care setting, insurance, hydroxyurea adherence, and opioid use disorders. Inpatient costs were the highest, followed by emergency and outpatient settings. Adjusted to the 2024 inflation rate, annual VOC hospitalization costs totaled $808.86 million, and median hospital charges ranged from $16,730.83 to $21,389.78. Medicaid inpatient costs were $30,378.70, 16.0% higher than commercial ($26,182.30) and 6.9% higher than Medicare ($28,422.48). VOC-related hospitalization costs for patients with opioid use disorder were 13.2% higher than those without. Non-adherent hydroxyurea patients had 65.2% higher VOC costs than adherent patients.
CONCLUSIONS: Managing VOCs in SCD patients imposes a significant economic burden, with costs varying based on type of medical service, presence of comorbid conditions, and treatment adherence
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE4
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
STA: Genetic, Regenerative & Curative Therapies