OBJECTIVES

This study assessed the real-world healthcare resource utilization (HRU) and costs, and productivity loss associated with rotator cuff repair (RCR) by tear type.

METHODS

: Adult (age>=18 years) Rotator cuff tear (RCT) patients from 2013-2017 with at least 12 months of continuous enrollment prior to and following the index date were identified retrospectively as partial or complete tear patients from the IBM Watson Health MarketScan® Commercial database using ICD-9/10-CM codes. Patients with incident RCR within 12 months post-index and 12 months continuous enrollment after the RCR date were analyzed. Post-surgical total and RCT-related healthcare costs (plan paid and patient out-of-pocket payment) and HRU were reported. Patients with absenteeism (ABS) or short-term disability (STD) claims, and attributable indirect costs were estimated.

RESULTS

: Total of 9,087 partial tear and 32,528 complete tear RCR patients were analyzed. All-cause post-surgical total costs was $34,086 per partial tear patient and $34,249 per complete tear patient (p=0.734). Overall, RCR patients had an average of 29 outpatient prescriptions and approximately 50 physical therapy visits 12 months post-surgery. About 90% of partial tear and 89% of complete tear patients had at least one prescription of opioid pain medication post-surgery. Combined physical therapy and outpatient prescription costs accounted for around 20% of all-cause and 11% of RCT-related spending post-surgery. Average total pre-surgical indirect cost was $1,073 and $924 for partial and complete tear patients respectively. ABS and STD costs was $5,843 (33 days) and $4,493 (37.5 days) for partial tear patients and $5,770 (33.7 days) and $4,382 (36.5 days) for complete tear patients.

CONCLUSIONS

: High direct costs impacted by rehabilitation (physiotherapy and prescription medications) and indirect costs are indicative of considerable post-surgical spending on recovery among RCT patients. Adopting strategies and proven technologies to enable early recovery can potentially help alleviate the HRU and economic burden of RCR.