PRE- TO POST-DIAGNOSIS INCREASE IN UTILIZATION AND COSTS OF CHRONIC-USE MEDICATIONS AND OTHER MEDICAL RESOURCES IN MANAGED CARE ENROLLEES WITH DIVERTICULITIS

Author(s)

Davis KL1, Yen L2, Loftus EV3, Hodgkins P21RTI Health Solutions, Research Triangle Park, NC, USA, 2Shire Development LLC., Wayne, PA, USA, 3Mayo Clinic, Rochester , MN, USA

OBJECTIVES: We assessed changes in utilization of common chronic-use medications and generalized all-cause medical services and costs pre- to post-diagnosis in a real-world diverticulitis (DV) population. METHODS: Insurance claims from >40 US health plans representing ~50 million lives were retrospectively analyzed. Inclusion criteria were: primary diagnosis of colonic DV (ICD-9 562.11, 562.13) between January 1, 2005 and December 31, 2008; antibiotic within 3 days post-diagnosis; ≥12 months pre- and post-diagnosis enrollment. Use of non-GI-related medications, as well as overall all-cause utilization and costs (2009 US$), were descriptively evaluated pre- to post-diagnosis. All-cause costs were also evaluated for non-DV controls matched 2:1 on age, gender, and plan enrollment, with index date assigned as diagnosis date of each respective DV match. RESULTS: A total of 25,172 patients met all inclusion criteria (51.2% male, mean age 53 years). The top 5 most prevalent chronic-use medications during pre-index were antihyperlipidemics (30.0% of patients), antihypertensives (27.5%), antidepressants (20.9%), dermatologicals (20.0%) and beta blockers (15.7%). Post-index use of these medications increased by 8.9%, 8.2%, 7.3%, 9.1%, and 11.7%, respectively (all P<0.010). Mean all-cause hospital days and costs per patient increased significantly pre- to post-index (0.9 vs. 2.3 days, $3223 vs. $6341; all P<0.010). Other significant (P<0.010) increases pre- to post-index were seen for ER visits (0.7 vs. 1.2; $432 vs. $1012), prescriptions (22 vs. 27 fills, $1910 vs. $2081), office visits (10 vs. 12, $1747 vs. $2251), and other outpatient/specialty consultations (3 vs. 5, $2676 vs. $4288) (all P<0.010). Total all-cause costs increased by 60% post-diagnosis ($10,419 vs. $16,672; P<0.010). Minimal change occurred for controls ($6299 vs. $6493; P=0.010). CONCLUSIONS: Patients with DV have higher use of common chronic-use prescriptions after diagnosis, as well as significantly higher use and costs of general all-cause medical services. Payers should be aware of increased costs for not only disease-related services, but also other general health care.

Conference/Value in Health Info

2012-06, ISPOR 2012, Washington, D.C., USA

Value in Health, Vol. 15, No. 4 (June 2012)

Code

PGI20

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Gastrointestinal Disorders

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