Health Care Burden in Patients With Adrenal Insufficiency

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Health Care Burden in Patients With Adrenal Insufficiency

Gunnarsson, C. (författare)

Ryan, M. P. (författare)

Marelli, C. (författare)

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Baker, E. R. (författare)

Stewart, P. M. (författare)

Johannsson, Gudmundur, 1960 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

Biller, B. M. K. (författare)

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(creator_code:org_t)

2017-04-12
2017
Engelska.
Ingår i: Journal of the Endocrine Society. - : The Endocrine Society. - 2472-1972. ; 1:5, s. 512-523

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Objective: This study aimed to estimate the annual health care burden for patients with adrenal insufficiency [AI; primary (PAI), secondary to pituitary disorder (PIT), and congenital adrenal hyperplasia (CAH)] using real-world data. Methods: Using a US-based payer database comprising >108 million members, strict inclusion criteria with diagnostic codes and pharmacy records were used to identify 10,383 patients with AI. This included 1014 patients with PAI, 8818 with PIT, and 551 with CAH, followed for >12 months. Patients were matched 1:1 to controls, based on age (+/- 5 years), sex, insurance, and region. Multivariable expenditure models were estimated for each AI cohort vs controls as well as subsets by glucocorticoid therapy (hydrocortisone, dexamethasone, prednisone, or multiple therapies). A separate multivariable model was estimated to assess the association between adherence and expenditures. Results: Total annual health care expenditure estimates were significantly higher (P < 0.0001) in all AI cohorts compared with matched controls (PAI $18,624 vs $4320, PIT $32,218 vs $6956, CAH $7677 vs $4203). Patients with AI have more frequent inpatient hospital stays with up to eight to 10 times more days in the hospital per year than their matched controls. In each AI cohort, patients on multiple steroid therapies had higher expenditures in comparison with patients using hydrocortisone therapy alone. In PAI and PIT cohorts taking hydrocortisone only, fewer expenditures were found in higher adherence subsets. Conclusion: Patients with AI demonstrate a substantial annual health care burden. Expenditures vary by underlying cause and treatment and are reduced in patients with higher adherence to glucocorticoid replacement. Copyright (c) 2017 Endocrine Society

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

adrenal insufficiency
hypoadrenalism
congenital adrenal hyperplasia
health care costs
health
therapy
disease
cohort

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Av författaren/redakt...: Gunnarsson, C.; Ryan, M. P.; Marelli, C.; Baker, E. R.; Stewart, P. M.; Johannsson, Gudm ...; visa fler...; Biller, B. M. K.; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Endokrinologi oc ...

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Av lärosätet: Göteborgs universitet

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