ASSOCIATION OF FATIGUE AND ACUTE PAIN WITH HEALTH CARE RESOURCE UTILIZATION AND COSTS IN SICKLE CELL DISEASE IN THE UNITED STATES
Author(s)
Jing Voon C. Dever, PhD1, Mihail Samnaliev, PhD2, Yi Pan, PhD2, Matthew Sussman, MA2, Scott Bunner, MPH3, Adam Wufsus, PhD1;
1Novo Nordisk Inc., Plainsboro, NJ, USA, 2Stratevi, Santa Monica, CA, USA, 3Genesis Research Group, Hoboken, NJ, USA
1Novo Nordisk Inc., Plainsboro, NJ, USA, 2Stratevi, Santa Monica, CA, USA, 3Genesis Research Group, Hoboken, NJ, USA
OBJECTIVES: This study evaluated whether fatigue or acute pain in patients with sickle cell disease (SCD) is associated with increased health care resource utilization (HCRU) and all-cause costs in the United States to better understand the economic impact of these SCD-related symptoms.
METHODS: The TriNetX Linked Network claims database and TriNetX Dataworks-USA electronic health record data were used to identify patients aged ≥12 years who were diagnosed with SCD between October 1, 2015, and June 21, 2024. Fatigue was defined as hemoglobin levels ≤10.0 g/dL (a proxy for fatigue) or an encounter with an ICD-10-CM diagnosis code for fatigue. Acute pain was defined as an emergency department or inpatient encounter with an ICD-10-CM diagnosis code for generic pain or SCD crisis, with intravenous pain medication administered during the encounter or an opioid prescription given within 7 days of the respective encounter. Multivariable regression models were used to estimate incremental annual HCRU and costs (2023 US dollars) to payers for patients with fatigue or pain and those without (controls).
RESULTS: The fatigue cohort comprised 960 patients with and 1,260 patients without fatigue. The acute pain cohort comprised 1,082 patients with and 884 patients without acute pain. In the respective cohorts, presence of fatigue or acute pain was associated with greater probability of adjusted HCRU, resulting in a statistically significant increase in adjusted average annual costs per patient of $7,500 (fatigue) and $6,108 (acute pain) compared with controls (all P<.001). Additional clinical predictors of significantly higher adjusted all-cause costs for both cohorts included hemoglobin-SD genotype, baseline transfusions, chronic obstructive pulmonary disease, sepsis, and baseline Charlson Comorbidity Index score (all P<.05).
CONCLUSIONS: Fatigue and acute pain were associated with greater probability of annual HCRU and increased associated costs among patients with SCD, highlighting the need for new treatments that address these unmet needs and associated economic burden.
METHODS: The TriNetX Linked Network claims database and TriNetX Dataworks-USA electronic health record data were used to identify patients aged ≥12 years who were diagnosed with SCD between October 1, 2015, and June 21, 2024. Fatigue was defined as hemoglobin levels ≤10.0 g/dL (a proxy for fatigue) or an encounter with an ICD-10-CM diagnosis code for fatigue. Acute pain was defined as an emergency department or inpatient encounter with an ICD-10-CM diagnosis code for generic pain or SCD crisis, with intravenous pain medication administered during the encounter or an opioid prescription given within 7 days of the respective encounter. Multivariable regression models were used to estimate incremental annual HCRU and costs (2023 US dollars) to payers for patients with fatigue or pain and those without (controls).
RESULTS: The fatigue cohort comprised 960 patients with and 1,260 patients without fatigue. The acute pain cohort comprised 1,082 patients with and 884 patients without acute pain. In the respective cohorts, presence of fatigue or acute pain was associated with greater probability of adjusted HCRU, resulting in a statistically significant increase in adjusted average annual costs per patient of $7,500 (fatigue) and $6,108 (acute pain) compared with controls (all P<.001). Additional clinical predictors of significantly higher adjusted all-cause costs for both cohorts included hemoglobin-SD genotype, baseline transfusions, chronic obstructive pulmonary disease, sepsis, and baseline Charlson Comorbidity Index score (all P<.05).
CONCLUSIONS: Fatigue and acute pain were associated with greater probability of annual HCRU and increased associated costs among patients with SCD, highlighting the need for new treatments that address these unmet needs and associated economic burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE506
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)