OBJECTIVES: Data on the economic burden of adhesive capsulitis (AC) in the United States are lacking. This study described surgery utilization and healthcare costs in patients newly diagnosed with AC.

METHODS: Adults aged ≥18 years with ≥1 AC diagnosis code were identified in the IQVIA PharMetrics® Plus database between January 1, 2016 to March 15, 2018; the first observed diagnosis was the index date. Patients were required to have 12 months of continuous enrollment before the index date (baseline), 24 months of follow-up after the index date, ≥1 additional AC diagnosis ≥30 days after the index date, and no diagnoses of acute calcific tendonitis/bursitis, shoulder arthrosis, shoulder bursitis, cervicalgia, cervical disc disorder, or rotator cuff tear during follow-up. Baseline patient characteristics, 24-month follow-up treatment patterns, and 12-month follow-up healthcare costs were described.

RESULTS: Among 10,729 AC patients, the majority were female (65.1%) and the mean (SD) age was 54.2 (9.2) years. Approximately half (50.2%) of all patients had evidence of risk factors for AC during baseline, including diabetes, hypertension, thyroid disease, and other comorbidities. Most patients (87.8%) had their last claim with AC diagnosis within 12 months after index. 859 patients (8.0%) had evidence of ≥1 AC-related surgery over 24-month follow-up, including shoulder manipulation under anesthesia (70.9% of surgical patients), arthroscopic capsular release (33.6%), and capsular contracture release (0.3%). 43.8% (N=376) of patients with surgery had subsequent physical or occupational therapy and/or corticosteroid injection. Mean (SD) 12-month total all-cause healthcare costs per patient were $11,968 ($24,358) for the entire AC cohort and $18,559 ($24,633) among the subgroup with surgery. Of patients with surgery anytime during 24-month follow-up, the mean total surgical cost per patient was $2,375 ($6,206).

CONCLUSIONS: In this real-world cohort of patients with AC, surgery is frequently followed by additional treatments to manage symptoms, which suggests unresolved AC.