Healthcare Resource Utilization for Medicare Patients with Non-Cystic Fibrosis Bronchiectasis (NCFB) and Exacerbations Coinfected with Pseudomonas aeruginosa
Author(s)
Michael E. Minshall, BS, MPH1, Jason J. LeCocq, MD, MBA2, Maia R. Emden, BA3, Naomi C. Sacks, PhD4;
1Zambon USA Ltd., HEOR and Market Access, Morristown, NJ, USA, 2Zambon USA Ltd., Medical Affairs, Morristown, NJ, USA, 3The George Washington University, Milken Institute of Public Health, Washington, DC, USA, 4HEORStrategies, a Division of ToxStrategies LLC, Boston, MA, USA
1Zambon USA Ltd., HEOR and Market Access, Morristown, NJ, USA, 2Zambon USA Ltd., Medical Affairs, Morristown, NJ, USA, 3The George Washington University, Milken Institute of Public Health, Washington, DC, USA, 4HEORStrategies, a Division of ToxStrategies LLC, Boston, MA, USA
Presentation Documents
OBJECTIVES: Non-Cystic Fibrosis Bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterized by irreversibly dilated airways and recurrent pulmonary infections. Concomitant bacterial infection with Pseudomonas aeruginosa (PsA) is associated with greater lung function impairment, exacerbations and hospitalization. NCFB exacerbations are defined as an increase in daily symptoms including cough, sputum production, malaise, fatigue, and breathing difficulty. The burden of NCFB with concomitant PsA will be examined.
METHODS: This retrospective longitudinal study utilized the Medicare Limited Data Set (LDS). Patients had ≥2 outpatient claims or ≥1 inpatient or emergency department (ED) claim for NCFB (ICD-10-CM: J47.XX or ICD-9-CM: 494.XX) and no cystic fibrosis diagnoses (01/01/2010-06/30/2021). PsA patients also had ≥1 claims for infection (ICD9: 041.7; ICD-10: B96-5) or pneumonia due to PsA. Patients with exacerbations had ≥1 NCFB hospitalization, ≥1 pneumonia (any), ≥2 exacerbations or IV antibiotic treatment. Outcomes were patient characteristics and annual healthcare resource utilization (HRU).
RESULTS: The LDS had a total of 22,075 NCFB patients, mean age 76.2±7.1, 60.9% female, PsA with exacerbations (PsA+ n=824, 3.7%), exacerbations and no PsA (PsA- n=10,870, 49.3%), and neither PsA nor exacerbations (PsA0 n=10,381, 47%). Average inpatient admissions/patient/year were highest among PsA+ (2.84) compared to PsA- (1.52) or PsA0 (0.30). Average inpatient length of stay (days)/patient/year were highest among PsA+ (12.03) compared to PsA- (7.48) or PsA0 (5.47). Outpatient encounters were highest among PsA+ (66.88±41.41) compared to PsA- (46.08±27.99) or PsA0 (32.92±20.58). Average annual injectable antibiotic treatments were highest among PsA+ (1.64) compared to PsA- (0.50) or PsA0 (0.18).
CONCLUSIONS: NCFB is associated with a large HRU burden in US Medicare patients, particularly among those with PsA and exacerbations. It is plausible that PsA is under-coded in the LDS thereby making some patients in our study grouped with exacerbations and no PsA actually belonging in the PsA with exacerbations group.
METHODS: This retrospective longitudinal study utilized the Medicare Limited Data Set (LDS). Patients had ≥2 outpatient claims or ≥1 inpatient or emergency department (ED) claim for NCFB (ICD-10-CM: J47.XX or ICD-9-CM: 494.XX) and no cystic fibrosis diagnoses (01/01/2010-06/30/2021). PsA patients also had ≥1 claims for infection (ICD9: 041.7; ICD-10: B96-5) or pneumonia due to PsA. Patients with exacerbations had ≥1 NCFB hospitalization, ≥1 pneumonia (any), ≥2 exacerbations or IV antibiotic treatment. Outcomes were patient characteristics and annual healthcare resource utilization (HRU).
RESULTS: The LDS had a total of 22,075 NCFB patients, mean age 76.2±7.1, 60.9% female, PsA with exacerbations (PsA+ n=824, 3.7%), exacerbations and no PsA (PsA- n=10,870, 49.3%), and neither PsA nor exacerbations (PsA0 n=10,381, 47%). Average inpatient admissions/patient/year were highest among PsA+ (2.84) compared to PsA- (1.52) or PsA0 (0.30). Average inpatient length of stay (days)/patient/year were highest among PsA+ (12.03) compared to PsA- (7.48) or PsA0 (5.47). Outpatient encounters were highest among PsA+ (66.88±41.41) compared to PsA- (46.08±27.99) or PsA0 (32.92±20.58). Average annual injectable antibiotic treatments were highest among PsA+ (1.64) compared to PsA- (0.50) or PsA0 (0.18).
CONCLUSIONS: NCFB is associated with a large HRU burden in US Medicare patients, particularly among those with PsA and exacerbations. It is plausible that PsA is under-coded in the LDS thereby making some patients in our study grouped with exacerbations and no PsA actually belonging in the PsA with exacerbations group.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD124
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)