Logo image
Back
The direct medical costs of Huntington's disease by stage. A retrospective commercial and Medicaid claims data analysis
Journal article   Open access   Peer reviewed

The direct medical costs of Huntington's disease by stage. A retrospective commercial and Medicaid claims data analysis

Victoria Divino, Mitch DeKoven, John H Warner, Joseph Giuliano, Karen E Anderson, Douglas Langbehn and Won Chan Lee
Journal of medical economics, Vol.16(8), pp.1043-1050
08/01/2013
DOI: 10.3111/13696998.2013.818545
PMID: 23789925
url
https://doi.org/10.3111/13696998.2013.818545View
Published (Version of record) Open Access

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.
 Cost of illness Burden of disease retrospective Huntington's disease costs of care claims analysis health care costs

Details

Metrics

80 Record Views
Logo image