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Erschienen in: Pituitary 6/2015

01.12.2015

Incremental healthcare resource utilization and costs in US patients with Cushing’s disease compared with diabetes mellitus and population controls

verfasst von: Michael S. Broder, Maureen P. Neary, Eunice Chang, William H. Ludlam

Erschienen in: Pituitary | Ausgabe 6/2015

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.
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Literatur
1.
Zurück zum Zitat Colao A, Boscaro M, Ferone D, Casanueva FF (2014) Managing Cushing’s disease: the state of the art. Endocrine 47(1):9–20CrossRefPubMed Colao A, Boscaro M, Ferone D, Casanueva FF (2014) Managing Cushing’s disease: the state of the art. Endocrine 47(1):9–20CrossRefPubMed
2.
Zurück zum Zitat Broder MS, Neary MP, Chang E, Cherepanov D, Ludlam WH (2014) Incidence of Cushing’s syndrome and Cushing’s disease in commercially-insured patients <65 years old in the United States. Pituitary [Epub ahead of print] Broder MS, Neary MP, Chang E, Cherepanov D, Ludlam WH (2014) Incidence of Cushing’s syndrome and Cushing’s disease in commercially-insured patients <65 years old in the United States. Pituitary [Epub ahead of print]
3.
Zurück zum Zitat Newell-Price J, Bertagna X, Grossman AB, Nieman LK (2006) Cushing’s syndrome. Lancet 367:1605–1617CrossRefPubMed Newell-Price J, Bertagna X, Grossman AB, Nieman LK (2006) Cushing’s syndrome. Lancet 367:1605–1617CrossRefPubMed
4.
Zurück zum Zitat Dekkers OM, Biermasz NR, Pereira AM, Roelfsema F, van Aken MO, Voormolen JH, Romijn JA (2007) Mortality in patients treated for Cushing’s disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 92:976–981CrossRefPubMed Dekkers OM, Biermasz NR, Pereira AM, Roelfsema F, van Aken MO, Voormolen JH, Romijn JA (2007) Mortality in patients treated for Cushing’s disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 92:976–981CrossRefPubMed
5.
Zurück zum Zitat Broder MS, Neary MP, Chang E, Ludlam WH, Cherepanov D (2013) Annual economic burden associated with Cushing’s disease in the United States. Presented at: ENDO 2013, 17 June 2013, San Francisco, CA Broder MS, Neary MP, Chang E, Ludlam WH, Cherepanov D (2013) Annual economic burden associated with Cushing’s disease in the United States. Presented at: ENDO 2013, 17 June 2013, San Francisco, CA
6.
Zurück zum Zitat Swearingen B, Wu N, Chen SY, Pulgar S, Biller BM (2011) Health care resource use and costs among patients with Cushing disease. Endocr Pract 17:681–690CrossRefPubMed Swearingen B, Wu N, Chen SY, Pulgar S, Biller BM (2011) Health care resource use and costs among patients with Cushing disease. Endocr Pract 17:681–690CrossRefPubMed
7.
Zurück zum Zitat Burton T, Le Nestour E, Neary M, Ludlam WH (2014) Economic burden of Cushing’s disease in a large US managed care health care plan. Presented at: ENDO 2014, 21–24 June 2014, Chicago, IL Burton T, Le Nestour E, Neary M, Ludlam WH (2014) Economic burden of Cushing’s disease in a large US managed care health care plan. Presented at: ENDO 2014, 21–24 June 2014, Chicago, IL
8.
Zurück zum Zitat Patil CG, Lad SP, Harsh GR, Laws ER Jr, Boakye M (2007) National trends, complications, and outcomes following transsphenoidal surgery for Cushing’s disease from 1993 to 2002. Neurosurg Focus 23(3):E7PubMed Patil CG, Lad SP, Harsh GR, Laws ER Jr, Boakye M (2007) National trends, complications, and outcomes following transsphenoidal surgery for Cushing’s disease from 1993 to 2002. Neurosurg Focus 23(3):E7PubMed
9.
Zurück zum Zitat Burton TM, Rey GG, Neary MP, Ludlam WH, Le Nestour E (2013) Development of an algorithm to identify Cushing disease patients in a US administrative claims database. Presented at: 13th International Pituitary Congress, 12–14 June 2013, San Francisco, CA Burton TM, Rey GG, Neary MP, Ludlam WH, Le Nestour E (2013) Development of an algorithm to identify Cushing disease patients in a US administrative claims database. Presented at: 13th International Pituitary Congress, 12–14 June 2013, San Francisco, CA
11.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMed
12.
Zurück zum Zitat Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619CrossRefPubMed Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619CrossRefPubMed
13.
Zurück zum Zitat Hwang W, Weller W, Ireys H, Anderson G (2001) Out-of-pocket medical spending for care of chronic conditions. Health Aff 20:267–278CrossRef Hwang W, Weller W, Ireys H, Anderson G (2001) Out-of-pocket medical spending for care of chronic conditions. Health Aff 20:267–278CrossRef
14.
15.
Zurück zum Zitat Brilleman SL, Purdy S, Salisbury C, Windmeijer F, Gravelle H, Hollinghurst S (2013) Implications of comorbidity for primary care costs in the UK: a retrospective observational study. Br J Gen Pract 63:e274–e282PubMedCentralCrossRefPubMed Brilleman SL, Purdy S, Salisbury C, Windmeijer F, Gravelle H, Hollinghurst S (2013) Implications of comorbidity for primary care costs in the UK: a retrospective observational study. Br J Gen Pract 63:e274–e282PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Meyers JL, Parasuraman S, Bell KF, Graham JP, Candrilli SD (2014) The high-cost, type 2 diabetes mellitus patient: an analysis of managed care administrative data. Arch Public Health 72:6PubMedCentralCrossRefPubMed Meyers JL, Parasuraman S, Bell KF, Graham JP, Candrilli SD (2014) The high-cost, type 2 diabetes mellitus patient: an analysis of managed care administrative data. Arch Public Health 72:6PubMedCentralCrossRefPubMed
17.
Zurück zum Zitat O’Shea M, Teeling M, Bennett K (2013) The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: a retrospective cross-sectional study using a national pharmacy claims database. BMC Health Serv Res 13:23PubMedCentralCrossRefPubMed O’Shea M, Teeling M, Bennett K (2013) The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: a retrospective cross-sectional study using a national pharmacy claims database. BMC Health Serv Res 13:23PubMedCentralCrossRefPubMed
18.
Zurück zum Zitat American Diabetes Association (2014) Standards of medical care in diabetes–2014. Diabetes Care 37(Suppl. 1):S14–S80CrossRef American Diabetes Association (2014) Standards of medical care in diabetes–2014. Diabetes Care 37(Suppl. 1):S14–S80CrossRef
19.
Zurück zum Zitat Buchfelder M, Schlaffer S (2010) Pituitary surgery for Cushing’s disease. Neuroendocrinology 92(Suppl 1):102–106CrossRefPubMed Buchfelder M, Schlaffer S (2010) Pituitary surgery for Cushing’s disease. Neuroendocrinology 92(Suppl 1):102–106CrossRefPubMed
21.
Zurück zum Zitat Patel DA, Maldonado M, Stephens JM, Pulgar S, Swearingen B (2011) Cost of second line non-pharmacologic interventions and their related complications in Cushing’s disease: A literature-based economic analysis. Presented at: 12th International Pituitary Congress, June 1–3, 2011, Boston, MA Patel DA, Maldonado M, Stephens JM, Pulgar S, Swearingen B (2011) Cost of second line non-pharmacologic interventions and their related complications in Cushing’s disease: A literature-based economic analysis. Presented at: 12th International Pituitary Congress, June 1–3, 2011, Boston, MA
22.
Zurück zum Zitat Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C, Hudson M, Mendoza J, Johnson R, Lin E, Umpierrez GE (2010) Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care 33:1783–1788PubMedCentralCrossRefPubMed Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C, Hudson M, Mendoza J, Johnson R, Lin E, Umpierrez GE (2010) Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care 33:1783–1788PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Aron DC (2010) Cushing’s syndrome: why is diagnosis so difficult? Rev Endocr Metab Disord 11:105–116CrossRefPubMed Aron DC (2010) Cushing’s syndrome: why is diagnosis so difficult? Rev Endocr Metab Disord 11:105–116CrossRefPubMed
24.
Zurück zum Zitat Bertagna X, Guignat L, Groussin L, Bertherat J (2009) Cushing’s disease. Best Pract Res Clin Endocrinol Metab 23:607–623CrossRefPubMed Bertagna X, Guignat L, Groussin L, Bertherat J (2009) Cushing’s disease. Best Pract Res Clin Endocrinol Metab 23:607–623CrossRefPubMed
25.
Zurück zum Zitat Tritos NA, Biller BM, Swearingen B (2011) Management of Cushing disease. Nat Rev Endocrinol 7:279–289CrossRefPubMed Tritos NA, Biller BM, Swearingen B (2011) Management of Cushing disease. Nat Rev Endocrinol 7:279–289CrossRefPubMed
26.
Zurück zum Zitat Feelders RA, Pulgar SJ, Kempel A, Pereira AM (2012) The burden of Cushing’s disease: clinical and health-related quality of life aspects. Eur J Endocrinol 167:311–326CrossRefPubMed Feelders RA, Pulgar SJ, Kempel A, Pereira AM (2012) The burden of Cushing’s disease: clinical and health-related quality of life aspects. Eur J Endocrinol 167:311–326CrossRefPubMed
Metadaten
Titel
Incremental healthcare resource utilization and costs in US patients with Cushing’s disease compared with diabetes mellitus and population controls
verfasst von
Michael S. Broder
Maureen P. Neary
Eunice Chang
William H. Ludlam
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Pituitary / Ausgabe 6/2015
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-015-0654-5

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