OBJECTIVES: Our previous analysis reported the economic burden of immune thrombocytopenia (ITP) among adult patients enrolled in Texas Medicaid. This study aimed to estimate the cost and health care utilization in children with ITP.

METHODS: A retrospective analysis was conducted using Texas Medicaid claims from 2012-2015. ITP patients aged 18 or under were identified using ICD-CM-9 code 287.31 and ICD-CM-10 code D69.3, with a requirement of two claims for ITP separated by at least 30 days. The index date was the first date with claims for ITP in the dataset. Patients were required to have continuous enrollment for 6 months before and 12 months after the index date. Outcomes included all-cause and ITP-related costs, costs attributed to different types of services, types of therapies used, emergency department (ED) visits and hospitalizations during the 12-month follow-up.

RESULTS: A total of 303 ITP children (47 % female) with a mean age of 6.7 years were included in the analyses. The average all-cause costs for 12 months were $19,140 (SD=$41,675) per person, including $3,123 drug costs and $16,017 non-drug medical costs. ITP-related costs were $8,994 (SD=$19,563), including $1,649 (18%) drug costs and $7,345 (82%) non-drug medical costs. More than half (55%) of non-drug medical costs were attributed to office visits, followed by hospitalizations (23%) and outpatient visits (20%); 40% of drug costs were attributed to IVIG, followed by rituximab (30%) and thrombopoietin receptor agonists (TPO-RAs) (18%). ITP-related costs were relatively higher in the first two months after initial diagnosis; 135 (45%) children received first-line therapies for ITP and 22 (7%) received second-line therapies;126 (42%) children had >=1 ITP-related hospitalization and 96 (32%) had >=1 ITP-related ED visits.

CONCLUSIONS: Office visits were the biggest contribution to ITP-related costs in children. ITP- related ER visits in children were more common compared to adults.