OBJECTIVES: Data on the impact of race on economic outcomes among patients with Duchenne muscular dystrophy (DMD) are lacking. This study sought to describe the all-cause healthcare costs among patients with DMD by race, in a Medicaid population.

METHODS: This was a retrospective cohort study of patients with DMD in the Merative Multi-State Medicaid Database between January 2017- June 2021. DMD patients were identified using a validated algorithm and included males with ≥2 DMD diagnoses (earliest diagnosis=index date), aged 40 years or younger, with at least 12 months of continuous enrollment prior to and 12 months (or evidence of death) following the index date were selected. Demographics, clinical characteristics, and all-cause healthcare utilization and costs were reported by race in the 12-month baseline and 12-month follow-up periods

RESULTS: 561 patients were included, of which 360 were White, 50 Black, 33 Hispanic, and 118 other/unknown. Median age on the index date was 16, 13, 14, and 15 years among the race categories, respectively. In both the baseline and follow-up periods, differences in total healthcare costs were not significantly different across racial cohorts. In the follow-up period, mean healthcare costs were numerically higher among the White cohort ($108,895; SD: $346,934) compared to $59,501 (SD: $85,758) in the Black cohort, $61,199 (SD: $67,021) in the Hispanic cohort, and $65,247 (SD: $119,733) in the unknown/other cohort. Differences in total healthcare costs across races were driven by differences in outpatient pharmacy costs, due to higher utilization of exon-skipping medications among White patients. Inpatient costs were significantly different, with unknown/other and Black patients incurring highest costs and White patients incurring lowest costs.

CONCLUSIONS: While total all-cause healthcare costs did not differ significantly by race among males with DMD, numerical differences were observed primarily due to variation in treatment utilization.