OBJECTIVES : The treatment landscape for sickle cell disease (SCD) has changed with recent approval of new treatments. This study investigated healthcare utilization and costs among individuals diagnosed with SCD enrolled in Mississippi(MS) Medicaid.

METHODS : A retrospective analysis was conducted using 2013-2020 Mississippi Medicaid administrative claims data, to identify beneficiaries with SCD. Included beneficiaries were required to have continuous eligibility for 12 months prior (baseline) and at least 12 months following (follow-up) the index date (earliest date of SCD diagnosis). Patients aged 65 years and above or having history of bone marrow transplant or diagnosis of sickle cell trait during baseline, were excluded. Baseline demographics, clinical characteristics, healthcare utilization and cost were summarized using frequencies and percentages for categorical variables and means and standard deviations (SD) for continuous and count variables.

RESULTS : The study included 1,132 SCD beneficiaries, with 62.3% of them being children. The mean(SD) baseline Elixhauser Comorbodity score was 0.48 (0.76) and 1.54(1.8) for children and adults respectively. Approximately, 33.3% and 41.9% of children and adults diagnosed with SCD, had any baseline vaso-occlusive crises (VOCs). Outpatient visits were the biggest driver of healthcare utilization for both children [Mean(SD): 26.61(20.41)] and adults [Mean(SD): 53.32(51.44)]. SCD-related visits constituted 24.5% and 13.9% of the outpatient visits for the children and adults respectively. Average annual healthcare cost among children was $14,053.33 (SD: $22,224.22), with 67.3% of the costs being SCD-related. Among adults, annual healthcare cost was much higher at $33,210.30 (SD: $86,408.29), with 49.8% being SCD-related. Pharmacy costs were the major drivers of healthcare expenditures among both children and adults, with 83.3% and 60.3% of the pharmacy costs being SCD-related among children and adults respectively.

CONCLUSIONS : The high pharmacy cost creates a significant burden in the MS Medicaid population diagnosed with SCD. Future research is needed to understand healthcare utilization, expenditures and their predictors in this population.