OBJECTIVES: Sickle cell disease (SCD) is characterized by sickled red blood cells, which lead to vaso-occlusive crises (VOCs), significant morbidity, and long-term mortality due to end-organ damage. This study describes the healthcare resource utilization (HCRU) among patients with SCD with recurrent VOCs in Germany.

METHODS: This longitudinal, retrospective cohort study utilized statutory health insurance records (Betriebskrankenkasse data source) in Germany to identify patients with a diagnosis for SCD between January 1, 2010, and December 31, 2018 (eligibility period). Eligible patients with SCD had ≥2 VOCs/year in 2 consecutive years; patients who had received a hematopoietic stem cell transplant were excluded. A VOC was defined as SCD with pain crisis, priapism, or acute chest syndrome. Patients were required to have data for ≥1 year before and after their index date (the second VOC in the second year of 2 consecutive years). Patients were followed from index until the earliest of death, deregistration due to patient leaving the data source, or end of study period (December 31, 2019). Demographics were assessed at index. Rates (per-patient-per-year [PPPY]) of VOCs and HCRU, including outpatient visits, hospitalizations, and pharmacy prescriptions, were summarized during follow-up.

RESULTS: In total, 84 patients with SCD with recurrent VOCs were included; 37 (44.0%) were female, and their mean (standard deviation [SD]) age at index was 40.1 (26.0) years. Average length of follow-up was 6.0 years. Patients experienced an average of 4.0 (SD=3.9) VOCs PPPY during follow-up. Mean rate of outpatient visits across all specialties was 24.5 (SD=15.3) PPPY. During follow-up, patients averaged 1.9 (SD=2.5) hospitalizations PPPY and 24.0 (SD=30.4) pharmacy prescriptions PPPY.

CONCLUSIONS: These results demonstrate that patients with SCD and recurrent VOCs have substantial HCRU driven by VOCs, hospitalizations, and outpatient visits. Innovative therapies that eliminate VOCs hold promise to reduce the clinical and economic burden associated with SCD.