Incidence-based cost estimates require population-based incidence data. A critique of Mahan et al.

Grosse, Scott D.

doi:10.1160/th11-09-0666

Cited by 29 publications

(19 citation statements)

References 33 publications

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“…Aggregate cost estimates calculated by using the same ascertainment methods both to identify affected persons and to estimate per-person costs are preferred. 23 …”

Section: Discussionmentioning

confidence: 99%

Employer-Sponsored Plan Expenditures for Infants Born Preterm

et al. 2017

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BACKGROUND Care for infants born preterm or with major birth defects is costly. Specific estimates of financial burden for different payers are lacking, in part because use of administrative data to identify preterm infants and costs is challenging. METHODS We used private health insurance claims data and billing codes to identify live births during 2013 and calculated first-year expenditures for employer-sponsored health plans for infants born preterm, both overall and stratified by major birth defects. RESULTS We conservatively estimated that 7.7% of insured infants born preterm accounted for 37% of $2.0 billion spent by participating plans on the care of infants born during 2013. With a mean difference in plan expenditures of ~$47 100 per infant, preterm births cost the included plans an extra $600 million during the first year of life. Extrapolating to the national level, we projected aggregate employer-sponsored plan expenditures of $6 billion for infants born preterm during 2013. Infants with major birth defects accounted for 5.8% of preterm births but 24.5% of expenditures during infancy. By using an alternative algorithm to identify preterm infants, it was revealed that incremental expenditures were higher: $78 000 per preterm infant and $14 billion nationally. CONCLUSION Preterm births (especially in conjunction with major birth defects) represent a substantial burden on payers, and efforts to mitigate this burden are needed. In addition, researchers need to conduct studies using linked vital records, birth defects surveillance, and administrative data to accurately and longitudinally assess per-infant costs attributable to preterm birth and the interaction of preterm birth with major birth defects.

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“…Aggregate cost estimates calculated by using the same ascertainment methods both to identify affected persons and to estimate per-person costs are preferred. 23 …”

Section: Discussionmentioning

confidence: 99%

Employer-Sponsored Plan Expenditures for Infants Born Preterm

et al. 2017

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“…Following publication of a critique [6] of published estimates of the economic burden of VTE in the US [7], the author of that critique (SDG) conducted a non-structured literature review in late 2013. To maximize comparability, only studies based on US data published since 2002 were included for the primary search for estimates of first-year treatment costs for patients with an incident VTE.…”

Section: Methodsmentioning

confidence: 99%

“…It causes long-term morbidity, notably post-thrombotic syndrome (PTS) following DVT and chronic thromboembolic pulmonary hypertension (CTEPH) following PE. Medical costs for VTE in the US have been estimated to total $5–10 billion per year [6]. Published estimates of the total economic impact of VTE, including the value of lost economic output due to premature mortality, are as high as $69 billion per year [7,8].…”

Section: Introductionmentioning

confidence: 99%

The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs

Grosse

Nelson

Nyarko

et al. 2016

Thrombosis Research

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Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is an important cause of preventable mortality and morbidity. In this study, we summarize estimates of per-patient and aggregate medical costs or expenditures attributable to incident VTE in the United States. Per-patient estimates of incremental costs can be calculated as the difference in costs between patients with and without an event after controlling for differences in underlying health status. We identified estimates of the incremental per-patient costs of acute VTEs and VTE-related complications, including recurrent VTE, post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension, and anticoagulation-related adverse drug events. Based on the studies identified, treatment of an acute VTE on average appears to be associated with incremental direct medical costs of $12,000 to $15,000 (2014 US dollars) among first-year survivors, controlling for risk factors. Subsequent complications are conservatively estimated to increase cumulative costs to $18,000–23,000 per incident case. Annual incident VTE events conservatively cost the US healthcare system $7–10 billion each year for 375,000 to 425,000 newly diagnosed, medically treated incident VTE cases. Future studies should track long-term costs for cohorts of people with incident VTE, control for comorbid conditions that have been shown to be associated with VTE, and estimate incremental medical costs for people with VTE who do not survive. The costs associated with treating VTE can be used to assess the potential economic benefit and cost-savings from prevention efforts, although costs will vary among different patient groups.

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“…Inclusion of these costs in our cost of illness models would significantly increase total, hospital associated and preventable costs. Of importance, the lower end of Grosse's earlier estimates for VTE in 2011 differ by 40% when compared to his current estimates highlighting the importance of actually building economic all encompassing models rather than making estimates [1,8]. In particular, we believe that the use of multistate Markov models fitted with rates of transition between different possible states (i.e.…”

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confidence: 71%