NMCP Delayed Time to Hospital Encounter and Reduced Cost compared to OMCP in Patients with Gastroparesis - A Real World Study
Author(s)
Ramaa Nathan, PhD1, Christopher Quesenberry, BS2, Pierantonio Russo, MD, FCPP, FAAP, STS2, Daniel Pfeffer, PhD2, Mostafa Shokoohi, PhD2.
1EVERSANA Life Sciences, Overland Park, KS, USA, 2Eversana Life Sciences, Overland Park, KS, USA.
1EVERSANA Life Sciences, Overland Park, KS, USA, 2Eversana Life Sciences, Overland Park, KS, USA.
OBJECTIVES: Oral metoclopramide (OMCP) is the standard treatment for gastroparesis (GP), but symptoms like delayed gastric emptying, nausea, and vomiting can hinder its efficacy. Diabetes, a common GP comorbidity, exacerbates these challenges. An intranasal metoclopramide (NMCP) formulation offers a non-oral alternative for patients with reduced oral medication efficacy or as initial treatment. This study evaluates the NMCP’s impact on healthcare costs over 12 months.
METHODS: A retrospective cost analysis using Merative MarketScan data (2020-2024) compared healthcare resource utilization (HCRU) and associated costs for NMCP and OMCP patients over 12 months. Entropy balancing, was used to match baseline covariates such as age, sex, insurance type, Elixhauser Comorbidity Index (ECI), and GP severity between the two cohorts. Costs included hospitalizations, emergency department (ED) visits, outpatient visits, and pharmacy claims. GP severity, determined from claims data using an adapted Gastroparesis Cardinal Symptom Index (GCSI), classified cases as severe (receiving procedures like jejunostomy, nasogastric, or PEG tubes, parenteral nutrition, enterectomy resection, inpatient endoscopy, gastric electric stimulation), moderate (inpatient, observation or ER visits for GP symptoms but not procedures), or mild (all other cases).
RESULTS: The analysis included 48 NMCP patients (67% female; median age: 41 years; severe: 8%; moderate: 21%) and 4,800 OMCP patients (78% female; median age: 51 years; severe: 10%; moderate: 26%). Entropy balancing achieved a standardized mean difference <0.1. Over 12 months, NMCP patients incurred average all cause monthly costs of $4,119 compared to $4,539 for OMCP (cost ratio: 0.91, 95% CI: 0.26-3.18). Time to hospitalization was delayed for NMCP patients (NMCP:10months; OMCP:7months; p=0.27). Time to first ER visit was also delayed (NMCP: 9 months; OMCP: 4 months; p < 0.05).
CONCLUSIONS: NMCP reduced healthcare costs by decreasing hospitalizations and ED visits, highlighting its value in GP management. Further research is planned to confirm long-term cost-effectiveness and identify key cost-saving drivers.
METHODS: A retrospective cost analysis using Merative MarketScan data (2020-2024) compared healthcare resource utilization (HCRU) and associated costs for NMCP and OMCP patients over 12 months. Entropy balancing, was used to match baseline covariates such as age, sex, insurance type, Elixhauser Comorbidity Index (ECI), and GP severity between the two cohorts. Costs included hospitalizations, emergency department (ED) visits, outpatient visits, and pharmacy claims. GP severity, determined from claims data using an adapted Gastroparesis Cardinal Symptom Index (GCSI), classified cases as severe (receiving procedures like jejunostomy, nasogastric, or PEG tubes, parenteral nutrition, enterectomy resection, inpatient endoscopy, gastric electric stimulation), moderate (inpatient, observation or ER visits for GP symptoms but not procedures), or mild (all other cases).
RESULTS: The analysis included 48 NMCP patients (67% female; median age: 41 years; severe: 8%; moderate: 21%) and 4,800 OMCP patients (78% female; median age: 51 years; severe: 10%; moderate: 26%). Entropy balancing achieved a standardized mean difference <0.1. Over 12 months, NMCP patients incurred average all cause monthly costs of $4,119 compared to $4,539 for OMCP (cost ratio: 0.91, 95% CI: 0.26-3.18). Time to hospitalization was delayed for NMCP patients (NMCP:10months; OMCP:7months; p=0.27). Time to first ER visit was also delayed (NMCP: 9 months; OMCP: 4 months; p < 0.05).
CONCLUSIONS: NMCP reduced healthcare costs by decreasing hospitalizations and ED visits, highlighting its value in GP management. Further research is planned to confirm long-term cost-effectiveness and identify key cost-saving drivers.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
MSR25
Topic
Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders