OBJECTIVES: Sickle cell disease (SCD) is a hereditary red blood cell (RBC) disorder characterized by sickle-shaped RBCs due to abnormal hemoglobin leading to hemolysis, vaso-occlusive crises (VOCs), and significant morbidity and mortality. This study aimed to understand healthcare resource utilization (HCRU) among patients with SCD with recurrent VOCs in Ontario, Canada.

METHODS: This longitudinal, retrospective cohort study utilized administrative datasets from the Institute for Clinical Evaluative Sciences in Ontario, Canada, to identify patients with a SCD diagnosis from 01/01/2010‒12/31/2021. Patients with SCD who had ≥2 VOCs/year in any 2 consecutive years were eligible for inclusion. A VOC was defined as SCD with crisis, priapism, or acute chest syndrome. The index date was the date of the second VOC in the second consecutive year. Patients were required to have ≥1 year of continuous enrollment pre- and post-index. Patients were followed from index until censoring, defined as death, loss to follow-up, most recent data availability, receipt of a hematopoietic stem cell transplant, or end of the study period (12/31/2022), whichever occurred first. Demographics were assessed at index and HCRU outcomes were summarized during follow-up.

RESULTS: Of the 3,801 patients with SCD, 859 met the inclusion criteria for SCD with recurrent VOCs. The mean age of patients was 22.1 years, and 50.9% were female. Mean follow-up was 7.4 years. Patients had a mean of (all per patient per year [PPPY]) 1.6 inpatient hospitalizations, 11.7 days spent in the hospital, and 3.0 emergency department visits. Additionally, patients had a mean of 3.6 and 6.3 outpatient general practitioner and outpatient specialist visits PPPY, respectively. Patients eligible for a public drug plan with ≥1 prescription during follow-up (n=777) had a mean of 19.4 prescriptions PPPY.

CONCLUSIONS: There is substantial HCRU associated with the care of patients with SCD in Canada, driven by frequent hospitalizations.