Incidence, Prevalence, and Economic Burden of Granulomatosis with Polyangiitis and Microscopic Polyangiitis in the United States
Author(s)
Elizabeth A. Ibiloye, MS, PhD1, Niranjan Kathe, MS, PhD1, Jasjit Multani, MPH2, Chi-Chang Chen, PhD, MsPharm2, Marie Yasuda, PharmD, MS2, Hsiu-Ching Chang, PhD2, Alana M. Bozeman, MD1, Sam Oh, PhD, MPH1, Zachary S. Wallace, MD, MSc1;
1Amgen, Thousand Oaks, CA, USA, 2IQVIA, Durham, NC, USA
1Amgen, Thousand Oaks, CA, USA, 2IQVIA, Durham, NC, USA
Presentation Documents
OBJECTIVES: Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), specifically granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), can cause blood vessel inflammation leading to life-and organ-threatening disease. We assessed the epidemiology and economic burden of GPA/MPA in the United States (US).
METHODS: This retrospective study of IQVIA Open-Source and PharMetrics® Plus claims data (01/01/20-12/31/23) included patients with ≥2 medical claims with a GPA/MPA/AAV diagnosis and continuous data availability during the calendar year for incidence and prevalence assessments and continuous enrollment 12 months pre-and post-index (earliest diagnosis) for economic burden assessment. Patients with eosinophilic granulomatosis with polyangiitis diagnosis or mepolizumab prescription were excluded. For each calendar year, incident and prevalent patient counts and the corresponding denominator of patients in the IQVIA data were assessed and projected to the census-level US population. Total adjudicated healthcare use and costs over the 1-year post-index period were estimated and stratified by relapse (defined as inpatient/emergency department visit for GPA/MPA or related conditions accompanied by an increased glucocorticoid dosage) and by end-stage kidney disease (ESKD) diagnosis.
RESULTS: For 2021-2023, the average projected annual incidence and prevalence (range) were 3.12 (2.47-3.86) and 12.88 (10.09-15.76) per 100,000 persons, respectively. The economic assessment involved 2,092 patients. Of the 544 (26.0%) patients with ≥1 relapse and 1548 (74%) without a relapse, 252 (46.3%) and 321 (20.7%), respectively, had ≥1 hospitalization. Of the 234 (11.2%) patients with ESKD and 1858 (88.8%) without ESKD, 151 (64.5%) and 422 (22.7%), respectively, had ≥1 hospitalization. The mean annual all-cause healthcare costs for patients with GPA/MPA, ≥1 relapse, and ESKD were $54,891, $82,514, and $147,994, respectively.
CONCLUSIONS: The study provides updated national incidence and prevalence estimates for GPA/MPA and highlights the economic burden among patients who relapse or have ESKD. Targeted interventions that reduce relapse and slow the progression to ESKD may reduce healthcare use for patients with GPA/MPA.
METHODS: This retrospective study of IQVIA Open-Source and PharMetrics® Plus claims data (01/01/20-12/31/23) included patients with ≥2 medical claims with a GPA/MPA/AAV diagnosis and continuous data availability during the calendar year for incidence and prevalence assessments and continuous enrollment 12 months pre-and post-index (earliest diagnosis) for economic burden assessment. Patients with eosinophilic granulomatosis with polyangiitis diagnosis or mepolizumab prescription were excluded. For each calendar year, incident and prevalent patient counts and the corresponding denominator of patients in the IQVIA data were assessed and projected to the census-level US population. Total adjudicated healthcare use and costs over the 1-year post-index period were estimated and stratified by relapse (defined as inpatient/emergency department visit for GPA/MPA or related conditions accompanied by an increased glucocorticoid dosage) and by end-stage kidney disease (ESKD) diagnosis.
RESULTS: For 2021-2023, the average projected annual incidence and prevalence (range) were 3.12 (2.47-3.86) and 12.88 (10.09-15.76) per 100,000 persons, respectively. The economic assessment involved 2,092 patients. Of the 544 (26.0%) patients with ≥1 relapse and 1548 (74%) without a relapse, 252 (46.3%) and 321 (20.7%), respectively, had ≥1 hospitalization. Of the 234 (11.2%) patients with ESKD and 1858 (88.8%) without ESKD, 151 (64.5%) and 422 (22.7%), respectively, had ≥1 hospitalization. The mean annual all-cause healthcare costs for patients with GPA/MPA, ≥1 relapse, and ESKD were $54,891, $82,514, and $147,994, respectively.
CONCLUSIONS: The study provides updated national incidence and prevalence estimates for GPA/MPA and highlights the economic burden among patients who relapse or have ESKD. Targeted interventions that reduce relapse and slow the progression to ESKD may reduce healthcare use for patients with GPA/MPA.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE28
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Rare & Orphan Diseases, SDC: Urinary/Kidney Disorders