Estimating the Burden of Illness and Healthcare Costs Among Incident Intermittent Catheter Users: A Comparison of Neurogenic and Non-Neurogenic Bladder Cohorts in the US
Author(s)
George Skountrianos, BS, MS, Stacy Haddad, MS;
Hollister Incorporated, Global Market Access, Libertyville, IL, USA
Hollister Incorporated, Global Market Access, Libertyville, IL, USA
Presentation Documents
OBJECTIVES: This study assessed healthcare resource utilization (HCRU) and costs associated with all-cause, urinary tract infection (UTI)-related, and urinary retention (UR)-related events among incident intermittent catheter (IC) users in the United States, comparing neurogenic bladder (NGB) and non-neurogenic bladder (non-NGB) cohorts.
METHODS: Retrospective analysis conducted using Optum's de-identified Clinformatics® Data Mart Database (2016-2023). Eligible patients were incident IC users identified through HCPCS codes (A4351, A4352, A4353) with continuous commercial or Medicare Advantage health plan enrollment during a 1-year baseline and at least 2-month post-index period. Patients were required to have no prior IC use and to maintain IC use for at least 2 months post-index. Patients were classified as NGB or non-NGB based on ICD-10 diagnostic codes within the year preceding IC initiation. HCRU endpoints included hospitalizations and emergency room (ER) visits, stratified by all-cause, UTI-related, and UR-related etiologies; annual standardized costs were calculated. Differences between cohorts were evaluated using Chi-square, Kaplan-Meier, and Welch’s t-tests.
RESULTS: Among ~40,000 incident IC users, 57% were classified as NGB and 33% as non-NGB. NGB patients were younger (mean age 69.9 vs. 71.8 years), more likely to be female (60.0% vs. 24.0%), and more often immunosuppressed (9.2% vs. 4.6%). They also had higher prevalence of baseline comorbidities, including hypertension, cardiovascular disease, and infections. During the 12-month follow-up, NGB patients had significantly higher rates of hospitalizations and ER visits for all-cause (40-54% higher), UTI-related (26-58% higher), and UR-related events (61-74% higher). Average annualized costs were also higher for NGB patients: $75,125 vs. $45,144 (all-cause), $15,347 vs. $7,294 (UTI-related), and $10,350 vs. $7,823 (UR-related).
CONCLUSIONS: Incident IC users with NGB incur significantly greater HCRU and costs compared to non-NGB users. These findings highlight the substantial economic burden of NGB in the IC population and the need for targeted interventions for this high-risk group.
METHODS: Retrospective analysis conducted using Optum's de-identified Clinformatics® Data Mart Database (2016-2023). Eligible patients were incident IC users identified through HCPCS codes (A4351, A4352, A4353) with continuous commercial or Medicare Advantage health plan enrollment during a 1-year baseline and at least 2-month post-index period. Patients were required to have no prior IC use and to maintain IC use for at least 2 months post-index. Patients were classified as NGB or non-NGB based on ICD-10 diagnostic codes within the year preceding IC initiation. HCRU endpoints included hospitalizations and emergency room (ER) visits, stratified by all-cause, UTI-related, and UR-related etiologies; annual standardized costs were calculated. Differences between cohorts were evaluated using Chi-square, Kaplan-Meier, and Welch’s t-tests.
RESULTS: Among ~40,000 incident IC users, 57% were classified as NGB and 33% as non-NGB. NGB patients were younger (mean age 69.9 vs. 71.8 years), more likely to be female (60.0% vs. 24.0%), and more often immunosuppressed (9.2% vs. 4.6%). They also had higher prevalence of baseline comorbidities, including hypertension, cardiovascular disease, and infections. During the 12-month follow-up, NGB patients had significantly higher rates of hospitalizations and ER visits for all-cause (40-54% higher), UTI-related (26-58% higher), and UR-related events (61-74% higher). Average annualized costs were also higher for NGB patients: $75,125 vs. $45,144 (all-cause), $15,347 vs. $7,294 (UTI-related), and $10,350 vs. $7,823 (UR-related).
CONCLUSIONS: Incident IC users with NGB incur significantly greater HCRU and costs compared to non-NGB users. These findings highlight the substantial economic burden of NGB in the IC population and the need for targeted interventions for this high-risk group.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE140
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Neurological Disorders, SDC: Urinary/Kidney Disorders