INCREMENTAL DIRECT AND INDIRECT COSTS OF SJOGREN'S DISEASE IN THE UNITED STATES: A RETROSPECTIVE ANALYSIS USING MARKETSCAN DATABASES
Author(s)
Dana DiRenzo, MD, MHS1, Shivangi Patel, PharmD, MS2, Niranjan Kathe, MS, PhD2, Laura C. Moore-Schiltz, PhD3, Virginia Noxon-Wood, PhD4, Annie Kilby, PhD2;
1Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA, 2Amgen Inc, Thousand Oaks, CA, USA, 3Inovalon, Shaker Heights, OH, USA, 4Inovalon, Bowie, MD, USA
1Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA, 2Amgen Inc, Thousand Oaks, CA, USA, 3Inovalon, Shaker Heights, OH, USA, 4Inovalon, Bowie, MD, USA
OBJECTIVES: To quantify the direct and indirect costs associated with Sjögren’s disease (SjD) compared to matched controls
METHODS: A retrospective cohort study was conducted using MarketScan Commercial Claims and Encounters (CCAE) and Health and Productivity Management (HPM) linked databases. Patients with ≥2 outpatient or ≥1 inpatient claim with a SjD diagnosis code (M35.0x) between July 2019 and December 2022 were included (earliest available SjD diagnosis=index date). Eligible patients had 12 months of continuous enrollment pre-index (CCAE only) and ≥12 months post-index enrollment in both databases. SjD patients were matched 1:2 to patients without SjD based on age, sex, and geographic region. Outcomes included healthcare resource utilization (HCRU), mean direct (pharmacy and medical) and mean indirect (workplace absenteeism and short- or long-term disability) costs. These outcomes were analyzed during a 12-month fixed follow-up period.
RESULTS: A total of 1,698 prevalent patients with SjD were matched to 3,396 controls. SjD patients demonstrated significantly greater HCRU, with higher proportions having ≥1 emergency room visit (27% vs. 19%), laboratory visit (97% vs. 79%), radiology service (82% vs. 60%), physician office visit (100% vs. 88%), and pharmacy fill (98% vs. 88%) (p<0.0001). Mean annual all-cause healthcare costs for SjD patients were almost three times that of controls ($27,147 vs. $9,736; p<0.0001). SjD-diagnosis related direct medical costs accounted for 23% of all-cause healthcare costs. SjD patients demonstrated significantly greater workplace absences (18 vs. 12 hours; p=0.00051) and short-term disability (66 vs. 27 hours; p<0.0001). SjD patients had significantly greater related costs secondary to workplace absences ($506 vs. $348; p=0.00074) and short-term disability ($1,280 vs. $520; p<0.0001).
CONCLUSIONS: SjD imposes a multifaceted burden on patients, employers, and the healthcare system. Patients with SjD experience higher HCRU, costs, and productivity losses compared with matched non-SjD populations. The significant direct and indirect cost differentials observed underscore the need for effective disease-modifying therapies.
METHODS: A retrospective cohort study was conducted using MarketScan Commercial Claims and Encounters (CCAE) and Health and Productivity Management (HPM) linked databases. Patients with ≥2 outpatient or ≥1 inpatient claim with a SjD diagnosis code (M35.0x) between July 2019 and December 2022 were included (earliest available SjD diagnosis=index date). Eligible patients had 12 months of continuous enrollment pre-index (CCAE only) and ≥12 months post-index enrollment in both databases. SjD patients were matched 1:2 to patients without SjD based on age, sex, and geographic region. Outcomes included healthcare resource utilization (HCRU), mean direct (pharmacy and medical) and mean indirect (workplace absenteeism and short- or long-term disability) costs. These outcomes were analyzed during a 12-month fixed follow-up period.
RESULTS: A total of 1,698 prevalent patients with SjD were matched to 3,396 controls. SjD patients demonstrated significantly greater HCRU, with higher proportions having ≥1 emergency room visit (27% vs. 19%), laboratory visit (97% vs. 79%), radiology service (82% vs. 60%), physician office visit (100% vs. 88%), and pharmacy fill (98% vs. 88%) (p<0.0001). Mean annual all-cause healthcare costs for SjD patients were almost three times that of controls ($27,147 vs. $9,736; p<0.0001). SjD-diagnosis related direct medical costs accounted for 23% of all-cause healthcare costs. SjD patients demonstrated significantly greater workplace absences (18 vs. 12 hours; p=0.00051) and short-term disability (66 vs. 27 hours; p<0.0001). SjD patients had significantly greater related costs secondary to workplace absences ($506 vs. $348; p=0.00074) and short-term disability ($1,280 vs. $520; p<0.0001).
CONCLUSIONS: SjD imposes a multifaceted burden on patients, employers, and the healthcare system. Patients with SjD experience higher HCRU, costs, and productivity losses compared with matched non-SjD populations. The significant direct and indirect cost differentials observed underscore the need for effective disease-modifying therapies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE85
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), STA: Biologics & Biosimilars