HEALTH CARE UTILIZATION AND COSTS ASSOCIATED WITH CONSTIPATION (C-ONLY) AND CO-OCCURRING IRRITABLE BOWEL SYNDROME AND CONSTIPATION (IBS+C) COMPARED TO MIGRAINE IN A LARGE MANAGED CARE POPULATION
Author(s)
Debanjali Mitra, MA, MBA, Research Health Economist1, Keith L. Davis, MA, Director, Health Economics1, Robert W Baran, RPh, PharmD, Senior Manager21RTI Health Solutions, Research Triangle Park, NC, USA; 2 Takeda Pharmaceuticals North America, Deerfield, IL, USA
OBJECTIVES: Health care utilization and costs may be elevated among patients with C-ONLY and IBS+C. Migraine is an appropriate comparator because it is chronic, costly, and non-gastrointestinal. Health care utilization and costs were evaluated for these three groups. METHODS: A large US health plan claims database was retrospectively analyzed from January 2003 through December 2005. Three mutually exclusive cohorts were identified: 1) C-ONLY: ICD-9 564.0x (N=91,632); 2) IBS+C: ICD-9 564.1 and 564.0x (N=10,952); and 3) Migraine: ICD-9 346.xx (N=101,418). Per patient use and costs (charged amounts) of medical services and prescriptions were assessed over a period of 3 months prior to and 9 months following first diagnosis. Patients had continuous health plan enrollment during this period. RESULTS: Total health care charges were $15,808 and $16,378 for patients with C-ONLY and IBS+C compared to $10,405 among patients with migraine (difference $5,403 and $5,973, both P<0.0001). Inpatient charges were approximately 2.5 times higher for the C-ONLY cohort and 1.7 times higher for the IBS+C cohort compared to migraine ($5,112 and $3,625, vs. $2,093; both P<0.0001). Both cohorts had higher charges for office visits compared to migraine ($2,460 and $3,050, vs. $2,282; both P<0.0001). Charges for hospital outpatient services were $3,913 and $4,738 for patients with C-ONLY and IBS+C, respectively, compared to $2,784 for migraine (both P<0.0001), while charges for other ancillary services were $2,578 and $2,627 for C-ONLY and IBS+C, respectively, compared to $1,444 for migraine (both P<0.0001). Prescription drug charges were slightly lower for C-ONLY, but higher for IBS+C compared to migraine ($1,438 and $2,053 vs. $1,551; both P<0.0001). Charges for ER visits were higher for both cohorts compared to migraine ($307 vs. $251, P<0.0001 and $284 vs. $251, P=0.0059). CONCLUSION: C-ONLY and IBS+C are costly conditions that present greater economic burden to payers compared to migraine. Institutional costs are primary drivers for constipation expenditures.
Conference/Value in Health Info
2007-05, ISPOR 2007, Arlington, VA, USA
Value in Health, Vol. 10, No.3 (May/June 2007)
Code
PGI7
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Gastrointestinal Disorders