Journal article
The direct medical costs of Huntington's disease by stage. A retrospective commercial and Medicaid claims data analysis
Journal of medical economics, Vol.16(8), pp.1043-1050
08/01/2013
DOI: 10.3111/13696998.2013.818545
PMID: 23789925
Abstract
Objective:
This study quantified the direct healthcare costs and major cost drivers among patients with Huntington's disease (HD), by disease stage in commercial and Medicaid databases.
Methods:
This retrospective database analysis used healthcare utilization/cost data for HD patients (ICD-9-CM 333.4) from Thomson Reuters' MarketScan Commercial and Medicaid 2002-2009 databases. Patients were classified by disease stage (Early/Middle/Late) by a hierarchical assessment of markers of disease severity, confirmed by literature review and key opinion leader input. Costs were measured over the follow-up time of each patient with total costs per patient per stage annualized using a patient-year cost approach.
Results:
Among 1272 HD patients, the mean age was similar in commercial (752 patients) and Medicaid (520 patients) populations (48.5 years (SD = 13.3) and 49.3 years (SD = 17.2), respectively). Commercial patients were evenly distributed by stage (30.5%/35.5%/34.0%; Early/Middle/Late). However, most (74.0%) Medicaid HD patients were classified as Late stage. The mean total annualized cost per patient increased by stage (commercial: $4947 (SD = $6040)-$22,582 (SD = $39,028); Medicaid: $3257 (SD = $5670)-$37,495 (SD = $27,111). Outpatient costs were the primary healthcare cost component. The vast majority (73.8%) of Medicaid Late stage patients received nursing home care and the majority (54.6%) of Medicaid Late stage costs were associated with nursing home care. In comparison, only 40.6% of commercial Late stage patients received nursing home care, which contributed to only 4.6% of commercial Late stage costs.
Conclusions:
The annual direct economic burden of HD is substantial and increased with disease progression. More late stage Medicaid HD patients were in nursing homes and for a longer time than their commercial counterparts, reflected by their higher costs (suggesting greater disease severity). Key limitations include the classification of patients into a single stage, as well as a lack of visibility into full long-term care/nursing home-related costs for commercial patients.
Details
- Title: Subtitle
- The direct medical costs of Huntington's disease by stage. A retrospective commercial and Medicaid claims data analysis
- Creators
- Victoria Divino - IMS HealthMitch DeKoven - IMS HealthJohn H Warner - CHDI Foundation, IncJoseph Giuliano - CHDI Foundation, IncKaren E Anderson - Georgetown UniversityDouglas Langbehn - University of IowaWon Chan Lee - IMS Health
- Resource Type
- Journal article
- Publication Details
- Journal of medical economics, Vol.16(8), pp.1043-1050
- Publisher
- Taylor & Francis
- DOI
- 10.3111/13696998.2013.818545
- PMID
- 23789925
- ISSN
- 1369-6998
- eISSN
- 1941-837X
- Language
- English
- Date published
- 08/01/2013
- Academic Unit
- Psychiatry; Psychological and Quantitative Foundations
- Record Identifier
- 9984003982402771
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