Annual Medical Costs and Healthcare Resource Use in Patients with Systemic Sclerosis in an Insured Population

Fürst, Daniel E.; Fernandes, Ancilla W.; Iorga, Şerban R.; Greth, Warren; Bancroft, T. A.

doi:10.3899/jrheum.120600

Cited by 32 publications

(40 citation statements)

References 29 publications

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“…Furst, et al also reported adjusted annual healthcare costs of $22,909 for patients with SSc and $6620 for matched controls, resulting in a cost difference of $16,288. The lower adjusted cost difference found in the current study ($12,820) may be explained by the different definition of matched controls used in Furst, et al 18 . The difference may also reflect that the Furst, et al study was conducted among patients in a managed care organization, where patients included in the current study were enrolled in fee-for-service health plans.…”

Section: Discussioncontrasting

confidence: 69%

“…The finding that direct healthcare costs are significantly higher for patients with SSc than controls is consistent with the literature. A claims data study by Furst, et al 18 reported unadjusted annual healthcare (medical and pharmacy) costs of $21,625 for patients with SSc and $6859 for matched controls, resulting in a cost difference of $14,766. These costs are comparable to the unadjusted annual healthcare cost ($22,016) for patients with SSc and cost difference ($16,039) found in our current study.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with SSc were eligible for inclusion if they had at least 1 medical claim with a diagnosis of SSc (International Classification of Diseases, 9th Revision, Clinical Modification code 710.1) in the inpatient (IP) or emergency room (ER) setting, or at least 2 medical claims with diagnoses of SSc on 2 different dates in the outpatient (OP) or other settings between January 1, 2005, and March 31, 2015. Two medical claims were required to limit potential misclassification, which tends to be higher in the OP setting compared to the IP and ER settings, as commonly done in the literature 18,19 . The date of the first observed SSc diagnosis was defined as the index date.…”

Section: Methodsmentioning

confidence: 99%

“…Given the considerable comorbidity burden of SSc and the availability of limited, and only partly effective, treatment options, it is not surprising that substantial healthcare costs associated with SSc have been reported 12 . However, the economic burden of SSc has been estimated in a limited number of studies [12][13][14][15][16][17] , with only 2 such studies 18,19 including US patients. One of them (Furst,et al 18 ) found that patients with SSc had significantly higher annual healthcare costs and healthcare resource utilization (HRU) than matched controls but only included data up to 2008, and thus may be outdated and not reflective of the current treatment landscape.…”

mentioning

confidence: 99%

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Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

Zhou

Fan²,

Tang³

et al. 2019

J Rheumatol

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Objective.To quantify healthcare resource utilization (HRU), work loss, and annual direct and indirect healthcare costs among patients with systemic sclerosis (SSc) compared to matched controls in the United States.Methods.Data were obtained from a large US commercial claims database. Patients were ≥ 18 years old at the index date (first SSc diagnosis) and had ≥ 1 SSc diagnosis in the inpatient (IP) or emergency room (ER) setting, or ≥ 2 SSc diagnoses on 2 different dates in the outpatient (OP) setting between January 1, 2005, and March 31, 2015; continuous enrollment was required during the followup period (12 months after the index date). Individuals with no SSc diagnoses were matched 1:1 to patients with SSc. Wilcoxon signed-rank and McNemar tests were used for comparisons and regressions with generalized estimating equations for adjusted OR (aOR) and incidence rate ratios (IRR) between 2 cohorts.Results.There were 2192 pairs of patients with SSc and matched controls included (mean age 57.6 yrs; 84.3% female); of these, 233 were eligible for work loss/indirect cost analyses. Compared to matched controls, patients with SSc had significantly higher HRU and costs during the 1-year followup period, IP admissions (adjusted IRR = 2.4), IP hospitalization days (adjusted IRR = 3.1), ER visits (adjusted IRR = 2.0), OP visits (adjusted IRR = 2.3), and days of work loss (adjusted IRR = 2.6). The adjusted difference in annual direct and indirect costs was US$12,820 and $3103, respectively (all p < 0.0001).Conclusion.Patients with SSc had a high direct and indirect economic burden postdiagnosis.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

Zhou

Fan²,

Tang³

et al. 2019

J Rheumatol

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“…Estimated yearly per‐patient direct, indirect and lost productivity costs range from 11,073 Euro in Italy (Belotti Masserini, Zeni, Cossutta, Soldi, & Fantini, ) to 18,453 Canadian dollars (126,006 Euro) in a Canadian sample (Bernatsky et al, ) to 17,365 US dollars (154,989 Euro) in a large US SSc population (Furst, Fernandes, Iorga, Greth, & Bancroft, ) to 22,459 Euro in a French cohort of SSc patients (Chevreul et al, ).…”

Section: Introductionmentioning

confidence: 99%

Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol

Kocher

Simon

Dwyer

et al. 2019

Journal of Advanced Nursing

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Aim The aim of the management of systemic sclerosis (MANOSS) study described in this protocol is to develop a chronic care model, based on a contextual analysis and stakeholder involvement, for patients living with the rare disease systemic sclerosis (SSc) in Switzerland. Design Applying an implementation science approach, this study starts with an explanatory sequential mixed method study for contextual analysis, followed by broad stakeholder involvement for model development and a Delphi study to reach consensus. Methods First, a quantitative cross‐sectional survey with patients and healthcare professionals (HPs) will be conducted to identify current practice patterns of chronic illness management and technology readiness. Second, qualitative interviews with patients, family members and HPs will be performed to gain a deeper understanding of care needs identified in the quantitative survey. Third, a model of care will be co‐created with input from patients, HPs and other experts. The eHealth enhanced Chronic Care Model will serve as a guiding framework. The new model and corresponding outcome parameters will be refined using a Delphi‐study approach to reach consensus on a testable model of care for persons living with SSc. The protocol has received research ethics committee approval in September 2018 by the Swiss Ethics Committee. Discussion The MANOSS study's participatory approach is essential for contextual fit of the model for patients with SSc in this setting. Subsequent feasibility testing and implementation are planned to evaluate the model's value in relation to health disparities faced by this patient population. Impact Patients living with this rare disease lack access to coordinated, specialized care and self‐management support from qualified HPs. Reengineering of current care, with consideration for technological opportunities, is warranted to meet patients’ and families’ needs.

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Work Productivity and Economic Burden of Systemic Sclerosis in a Multiethnic Asian Population

Liu

Kua

Low

2022

Arthritis Care & Research

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Objective. To assess work productivity, identify associated factors and evaluate the economic burden of systemic sclerosis (SSc) in a multiethnic Asian population.Methods. Data on employment status and work productivity loss were collected. Associations between demographic and disease characteristics and unemployment status, work productivity loss, and activity impairment were examined using logistic and linear regression analyses, as appropriate. Costs of unemployment and work productivity loss were estimated using the human capital approach.Results. Of 111 patients with a mean disease duration of 9.1 years, 33 (29.7%) were unemployed. Their mean age at unemployment was 44.2 years, equating to 22.8 years of lost employment. No demographic and disease characteristics were significantly associated with unemployment status in multivariable analysis. Of 73 employed patients, 39 (53.4%) reported work productivity loss, accounting for 45.9% of the working week. The presence of hyperlipidemia (coefficient -19.01, P = 0.03) was associated with work productivity loss in multivariable analysis. In total, 37 of 78 employed patients (47.4%) and 19 of 33 unemployed patients (57.6%) reported activity impairment, accounting for 42.2% and 50.0%, respectively, of the preceding week. The presence of hyperlipidemia (coefficient -18.56, P < 0.01) was associated with activity impairment in multivariable analysis. Annual cost of unemployment and work productivity loss were estimated to be $53,244 and $13,045 (Singapore dollar) per patient, respectively.Conclusion. SSc imposes significant unemployment and work productivity loss and causes a substantial economic burden to both affected individuals and society. Modifying the identified factors associated with unemployment and work productivity loss may reduce the burden of SSc.

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Annual Medical Costs and Healthcare Resource Use in Patients with Systemic Sclerosis in an Insured Population

Cited by 32 publications

References 29 publications

Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol

Work Productivity and Economic Burden of Systemic Sclerosis in a Multiethnic Asian Population

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