Incremental healthcare resource utilization and costs in US patients with Cushing’s disease compared with diabetes mellitus and population controls
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Resource utilization and costs in Cushing’s disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs.
Using 2008–2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs.
There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001).
CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.
KeywordsUtilization Costs Cost analysis Cushing disease Cushing syndrome Diabetes mellitus
The authors thank Gordon H. Sun, M.D., and Dasha Cherepanov, Ph.D., for assisting with the manuscript. This study was funded by Novartis Pharmaceuticals Corporation. Financial relationships with the organization that sponsored the research are as follows: Maureen P. Neary and William H. Ludlam are employees of Novartis Pharmaceuticals Corporation; Michael S. Broder and Eunice Chang are employees of Partnership for Health Analytic Research, LLC (PHAR), a health services research company that received funding for this research from Novartis. This study was presented at AMCP Nexus, Boston, MA, October 8–9, 2014.
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