Burden of acromegaly in the United States: increased health services utilization, location of care, and costs of care

Abstract

Background: Limited information is available on the utilization and healthcare costs among patients with acromegaly. The purpose of this study was to assess the impact of acromegaly on healthcare utilization and costs by locations of care (LoC).Methods: Patients with acromegaly and controls were identified from an analysis of drug and medical claims filed from January 2010 to April 2019 from a US employer database. Each patient with acromegaly was matched with 20 random controls (without acromegaly) selected from the database.Claims were tracked for 12 months postdiagnosis (or matched date for controls). Outcomes by LoC, including costs, services, and likelihood of use, were compared using 2-stage regression models or logistic regression models, controlling for demographic and job-related variables, and Charlson comorbidity index scores. Results: Claims from 60 patients with acromegaly and 1200 controls were analyzed. Compared with the control group, patients with acromegaly had significantly higher likelihoods of receiving care in a physician's office [odds ratio>1000], inpatient [OR=8.010], outpatient [OR=12.656], laboratory [OR=3.681], and 'other' locations [OR=4.033] (all p < 0.001), except in an emergency department(ED). Significantly more services were performed at each LoC for those with acromegaly (p < 0.01) but not in an ED. Total costs were more than 5-fold higher for the acromegaly cohort compared with controls (p < 0.05). Costs by LoC were consistently higher (p < 0.001) for patients with acromegaly vs.

Treatment Patterns, Adherence, Persistence, and Health Care Resource Utilization in Acromegaly: A Real-World Analysis

“…The proportion of inpatient admissions we observed for patients with acromegaly (34.6%) is considerably higher than the rate observed in the general population (5.2% in 2018) [ 44 ]. This finding is consistent with a previous study showing increased use of health care resources among patients with vs without acromegaly [ 20 ]. Not surprisingly, in this study, patients with more comorbidities had more outpatient services during the first year after diagnosis, which may reflect consultations with different specialists regarding management of comorbidities.…”

“…These are important considerations for patients with acromegaly, as the disorder and its comorbidities may require lifelong monitoring and medical therapy across multiple specialties [ 18 ]. RWE sheds light on diverse aspects of disease management, including treatment patterns, medication adherence and persistence, and health care resource utilization [ 19 , 20 ]. Updated evaluations of treatment patterns for acromegaly are needed to assess whether treatment recommendations and guidelines are followed, and to consider recent changes or updates in available therapies [ 2 , 4 , 12 ]; such information increases understanding of the impact of medication on patients’ disease outcomes and quality of life.…”

Multiobjective Optimization of Public Health Service Delivery Networks

“…An emergency scenario requires modifying the definition of the coverage facility by incorporating redundancy and referral of services to other facilities in the affected areas. The priority of one solution must be monitored [32] - [33]. Another aspect is identifying nearby feasible areas for grouping against a need.…”

Acromegaly screening in patients with hyperprolactinemia and pituitary adenoma

“…Распространенными осложнениями акромегалии являются заболевания сердечно-сосудистой системы, нарушения углеводного обмена, синдром обструктивного апноэ сна, заболевания опорно-двигательного аппарата, онкологические заболевания, синдром запястного канала, которые сами по себе являются распространенными и значимыми для пациентов [3][4][5][6][7]. Заподозрить избыток секреции гормона роста зачастую удается, только когда уже формируется комплекс вышеперечисленных заболеваний, так как первые проявления акромегалии могут быть неспецифичны.…”