Burden of illness and costs associated with eosinophilic granulomatosis with polyangiitis: evidence from a managed care database in the United States

Abstract

BACKGROUND: Data on the clinical and economic burden of eosinophilic granulomatosis with polyangiitis (EGPA) are limited. OBJECTIVE: To assess the real-world clinical and economic outcomes of patients diagnosed with EGPA vs patients with asthma (present in > 90% of EGPA cases) receiving treatment in the United States. METHODS: This retrospective cohort study (HO-17-17742) used administrative claims data (July 1, 2007-May 31, 2017) from the Optum Research Database. Eligible patients were aged at least 18 years at index (first date that patients met the EGPA or asthma cohort definition), with a minimum of 6 months of continuous health plan coverage before the index (baseline) period and

Improving Care in Eosinophil-Associated Diseases: A Charter

“…Many barriers can limit patient access to appropriate specialist care, including socioeconomic status, language, education, care availability, and geography [ 12 , 13 , 19 ]. Given the rarity of some of these conditions, expertise is often lacking in certain regions, which can mean patients either go without appropriate care or must travel long distances to access specialists.…”

“…In addition to the above barriers against access to appropriate care, patients with EADs may have more than one EAD, additional comorbidities, and/or complex, multisystem expression of a single EAD (e.g. EGPA or HES), and they may often see multiple clinicians who treat each disease or clinical manifestation independently, rather than providing the holistic approach that is frequently needed [ 13 , 36 , 44 ]. This lack of coordinated care can create an inadequate and siloed treatment approach that fails to achieve the best possible outcomes for the patient.…”

“…Poor understanding of the central role of eosinophilic inflammation in many of the EADs can result in suboptimal treatment choices and excessive OCS use [ 13 , 21 ]. Patients are often reliant on OCS or even multiple-use OCS in those with comorbid EADs, which are associated with life-altering acute and chronic adverse effects [ 23 , 25 , 27 ].…”

“…family, friends, caretakers, and colleagues) [ 4 , 12 – 14 ]. This burden is due to the severity of their illness [ 13 , 15 , 16 ] and a range of healthcare barriers, including delayed times to referral, diagnosis, and treatment, among others [ 12 , 17 , 18 ]. Furthermore, their lives are often disrupted by debilitating symptoms, associated flare-ups, and comorbid EAD-associated conditions that require regular visits to the emergency department, hospital admissions, and a ‘cycling’ between multiple healthcare professionals (HCPs) [ 6 , 13 , 15 , 19 ].…”

“…In many instances, these patient barriers and challenges stem from poor recognition of EADs by HCPs [ 12 , 14 , 20 – 22 ], which often leads to delays in receiving an accurate diagnosis, accessing specialist care, and receiving effective and safe treatments for the condition [ 12 , 13 , 19 ]. People with EADs often rely on long-term or intermittent oral corticosteroids (OCS), sometimes administered through multiple routes and in addition to other therapies, to suppress inflammatory activity and control their symptoms and disease flares [ 12 , 13 , 21 ]. Unfortunately, many commonly used treatments do not specifically target eosinophils despite these cells being a critical part of the underlying biological cause [ 6 , 7 ].…”