OBJECTIVES: HD patients are diagnosed and managed by a variety of provider types. The objective of this study was to understand the association between type of provider of newly diagnosed HD patients and healthcare resource utilization (HCRU) and cost.

METHODS: This was a retrospective analysis of MarketScan® Commercial Claims databases (1/1/2017-12/31/21) that included newly diagnosed US adult HD patients. The types of providers diagnosing HD patients were identified. Patients with data available 6 months pre/post diagnosis (index date; 7/1/2017-6/31/2021) were included. HCRU included hospitalizations, outpatient visits, and prescriptions 12 months post-diagnosis; total cost included in/outpatient services and prescriptions, adjusted to 2022USD. Generalized linear regression was used to evaluate association between HCRU outcomes/cost and diagnosing provider type.

RESULTS: 340 patients were included; mean age at index date was 49 years; 71.5% of patients had Charlson comorbidity index of 0; 56.5% were female; most resided in the South (41.8%) or North-central (33.2%) regions. Patients were diagnosed by neurologists (48.5%), primary-care providers (PCP) (35.6%), psychiatrists (3.5%), or others (12.4%). Older age and North-central region location were associated with diagnosis by neurologists. Patients diagnosed by PCPs or neurologists were significantly more likely to be managed by those types of providers during follow-up (P<0.05).

All-cause and HD-related outpatient visits were higher in patients diagnosed by PCPs (23.9, 5.1 per-patient-per-year) than neurologists (18.0, 2.4), psychiatrists (16.7, 1.67), or others (15.3, 2.4). Patients diagnosed by neurologists vs PCPs had significantly lower HD-related total non-medication cost (-$2,256; P<0.05). There were no significant associations between diagnosing provider type and other HCRU outcomes. 57% received antipsychotic and/or VMAT2 inhibitor treatment within the first-year post-diagnosis.

CONCLUSIONS: HD patients are most often diagnosed by neurologists or PCPs. Although the same type of provider who diagnosed the patient typically manages their HD follow-up, no differences in HCRU were found between provider types.