ECONOMIC BURDEN OF IDIOPATHIC INFLAMMATORY MYOPATHIES IN THE UNITED STATES: A RETROSPECTIVE CLAIMS DATA STUDY
Author(s)
Parisa Asad, PhD1, Didem Saygin, MD2, Thomas Scassellati Sforzolini, MS3, Andre Gladiator, PhD4, Joseph Servadio, PhD5, Shreyas Jarmale, BS6.
1argenx, Bassell, Switzerland, 2Rush University, Chicago, IL, USA, 3Genesis Research Group, Vero Beach, FL, USA, 4argenx, Zwijnaarde, Belgium, 5ZS Associates, Philadelphia, PA, USA, 6ZS Associates, Bangaluru, India.
1argenx, Bassell, Switzerland, 2Rush University, Chicago, IL, USA, 3Genesis Research Group, Vero Beach, FL, USA, 4argenx, Zwijnaarde, Belgium, 5ZS Associates, Philadelphia, PA, USA, 6ZS Associates, Bangaluru, India.
OBJECTIVES: Idiopathic inflammatory myopathies is a rare systemic autoimmune disease with distinct subtypes associated with muscle weakness, functional impairment, and substantial healthcare needs. This study characterized direct medical costs among patients with dermatomyositis (DM) and polymyositis (PM) and assessed changes in costs before and after diagnosis in routine clinical practice.
METHODS: This retrospective cohort study used de-identified closed claims data from the Komodo Healthcare Map database. Patients with DM or PM were identified by the presence of at least one inpatient claim or two outpatient claims occurring 30-365 days apart. Continuous enrollment for at least one year before and two years after diagnosis was required, and all patients were required not to have DM or PM diagnoses prior to index.
RESULTS: A total of 1,352 incident DM and 729 incident PM patients were identified between 2019 and 2023. Among DM patients, average total costs per patient, excluding drug costs, were $10,315 pre-index; $34,858 in the first year post-index; and $33,679 in the second year post-index. Total costs for PM patients were consistently higher compared to DM patients, with a similar absolute magnitude of cost increase (average total cost per patient per year: $17,007 pre-index; $41,892 first year post-index; $41,738 second year post-index). For both DM and PM, outpatient care was consistently the greatest contributor to costs (60-70%), with other contributors including home health (DM: 15-20%, PM: 11-28%) and unspecified visit types (10%). Only inpatient expenditure decreased between the two years post-diagnosis.
CONCLUSIONS: Patients with DM and PM experienced substantial healthcare expenditure both before and after diagnosis, with marked increases in the two years following diagnosis. These findings highlight the considerable healthcare burden associated with sustained management after diagnosis, underscoring the need for effective disease management strategies to improve patient outcomes while reducing healthcare utilization and expenditure.
METHODS: This retrospective cohort study used de-identified closed claims data from the Komodo Healthcare Map database. Patients with DM or PM were identified by the presence of at least one inpatient claim or two outpatient claims occurring 30-365 days apart. Continuous enrollment for at least one year before and two years after diagnosis was required, and all patients were required not to have DM or PM diagnoses prior to index.
RESULTS: A total of 1,352 incident DM and 729 incident PM patients were identified between 2019 and 2023. Among DM patients, average total costs per patient, excluding drug costs, were $10,315 pre-index; $34,858 in the first year post-index; and $33,679 in the second year post-index. Total costs for PM patients were consistently higher compared to DM patients, with a similar absolute magnitude of cost increase (average total cost per patient per year: $17,007 pre-index; $41,892 first year post-index; $41,738 second year post-index). For both DM and PM, outpatient care was consistently the greatest contributor to costs (60-70%), with other contributors including home health (DM: 15-20%, PM: 11-28%) and unspecified visit types (10%). Only inpatient expenditure decreased between the two years post-diagnosis.
CONCLUSIONS: Patients with DM and PM experienced substantial healthcare expenditure both before and after diagnosis, with marked increases in the two years following diagnosis. These findings highlight the considerable healthcare burden associated with sustained management after diagnosis, underscoring the need for effective disease management strategies to improve patient outcomes while reducing healthcare utilization and expenditure.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH256
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)