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Pandya BJ, Young C, Packnett ER, Xie B, Lillehaugen T, Block A, Bernacki K, Touya M, LeBlanc TW. Work absenteeism, disability, and lost wages among patients with acute myeloid leukemia and their caregivers: a cohort study using US administrative claims and productivity data. Expert Rev Pharmacoecon Outcomes Res 2024; 24:521-532. [PMID: 38294308 DOI: 10.1080/14737167.2024.2311305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE We describe the impact of acute myeloid leukemia (AML) diagnosis on workplace absenteeism and disability days among patients and their caregivers. METHODS This retrospective study included adults with newly diagnosed AML (2009-2019) and adult caregivers of patients with newly diagnosed AML, identified from the US Merative™ MarketScan® Commercial Database. The Merative MarketScan Health and Productivity Management Database provided linked patient-level records of workplace absence and short-term (STD) and long-term disability (LTD) data. Endpoints included workplace absence, STD and LTD for patients and caregivers during 12 months pre-AML (baseline) and ≤3 years' follow-up, and corresponding cost of work loss. RESULTS Patient workplace absence decreased in the months post-AML diagnosis, but the number of STD and LTD leave days claimed increased significantly by sixfold and fourfold, respectively. The proportion of patients making STD leave claims increased within 4-5 months of diagnosis, while the proportion making LTD leave claims increased significantly starting from month 5. Caregiver workplace absence peaked in the first 2 months post-diagnosis and remained elevated versus baseline throughout the study. CONCLUSION AML diagnosis leads to workplace absenteeism and increased economic burden for patients with AML and their caregivers.
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Affiliation(s)
- Bhavik J Pandya
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | | | - Bin Xie
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | - Alana Block
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | - Maelys Touya
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
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Udeze C, Evans KA, Yang Y, Lillehaugen T, Manjelievskaia J, Mujumdar U, Li N, Andemariam B. Correction to: Economic and Clinical Burden of Managing Sickle Cell Disease with Recurrent Vaso-Occlusive Crises in the United States. Adv Ther 2023; 40:5130. [PMID: 37695467 PMCID: PMC10567901 DOI: 10.1007/s12325-023-02629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Chuka Udeze
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | - Yoojung Yang
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | | | - Urvi Mujumdar
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Nanxin Li
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Biree Andemariam
- Division of Hematology-Oncology, University of Connecticut Health, 263 Farmington Avenue, Farmington, CT, 06030, USA.
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Udeze C, Evans KA, Yang Y, Lillehaugen T, Manjelievskaia J, Mujumdar U, Li N, Andemariam B. Economic and Clinical Burden of Managing Sickle Cell Disease with Recurrent Vaso-Occlusive Crises in the United States. Adv Ther 2023; 40:3543-3558. [PMID: 37332020 PMCID: PMC10329958 DOI: 10.1007/s12325-023-02545-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/04/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION The aim of this study was to describe the clinical complications, treatment use, healthcare resource utilization (HCRU), and costs among patients with sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs) in the US. METHODS Merative MarketScan Databases were used to identify patients with SCD with recurrent VOCs from March 1, 2010, to March 1, 2019. Inclusion criteria were ≥ 1 inpatient or ≥ 2 outpatient claims for SCD and ≥ 2 VOCs per year in any 2 consecutive years after the first qualifying SCD diagnosis. Individuals without SCD in these databases were used as matched controls. Patients were followed for ≥ 12 months, from their second VOC in the 2nd year (index date) to the earliest of inpatient death, end of continuous enrollment in medical/pharmacy benefits, or March 1, 2020. Outcomes were assessed during follow-up. RESULTS In total, 3420 patients with SCD with recurrent VOCs and 16,722 matched controls were identified. Patients with SCD with recurrent VOCs had a mean of 5.0 VOCs (standard deviation [SD] = 6.0), 2.7 inpatient admissions (SD 2.9), and 5.0 emergency department visits (SD 8.0) per patient per year during follow-up. Compared to matched controls, patients with SCD with recurrent VOCs incurred higher annual ($67,282 vs. $4134) and lifetime ($3.8 million vs. $229,000 over 50 years) healthcare costs. CONCLUSION Patients with SCD with recurrent VOCs experience substantial clinical and economic burden driven by inpatient costs and frequent VOCs. There is a major unmet need for treatments that alleviate or eliminate clinical complications, including VOCs, and reduce healthcare costs in this patient population.
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Affiliation(s)
- Chuka Udeze
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | - Yoojung Yang
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | | | - Urvi Mujumdar
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Nanxin Li
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Biree Andemariam
- Division of Hematology-Oncology, University of Connecticut Health, 263 Farmington Avenue, Farmington, CT, 06030, USA.
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Kim KD, Coric D, Khachatryan A, Brady BL, Lillehaugen T, McCormack M, Dolman WB, Ditto R. A real-world analysis of hybrid CDA and ACDF compared to multilevel ACDF. BMC Musculoskelet Disord 2023; 24:191. [PMID: 36918916 PMCID: PMC10012503 DOI: 10.1186/s12891-023-06284-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/01/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Multilevel anterior cervical discectomy and fusion (mACDF) is the gold standard for multilevel spinal disease; although safe and effective, mACDF can limit regular spinal motion and contribute to adjacent segment disease (ASD). Hybrid surgery, composed of ACDF and cervical disc arthroplasty, has the potential to reduce ASD by retaining spinal mobility. This study examined the safety of hybrid surgery by utilizing administrative claims data to compare real-world rates of subsequent surgery and post-procedural hospitalization within populations of patients undergoing hybrid surgery versus mACDF for multilevel spinal disease. METHODS This observational, retrospective analysis used the MarketScan Commercial and Medicare Database from July 2013 through June 2020. Propensity score matched cohorts of patients who received hybrid surgery or mACDF were established based on the presence of spinal surgery procedure codes in the claims data and followed over a variable post-period. Rates of subsequent surgery and post-procedural hospitalization (30- and 90-day) were compared between hybrid surgery and mACDF cohorts. RESULTS A total of 430 hybrid surgery patients and 2,136 mACDF patients qualified for the study; average follow-up was approximately 2 years. Similar rates of subsequent surgery (Hybrid: 1.9 surgeries/100 patient-years; mACDF: 1.8 surgeries/100 patient-years) were observed for the two cohorts. Hospitalization rates were also similar across cohorts at 30 days post-procedure (Hybrid: 0.67% hospitalized/patient-year; mACDF: 0.87% hospitalized/patient-year). At 90 days post-procedure, hybrid surgery patients had slightly lower rates of hospitalization compared to mACDF patients (0.23% versus 0.42% hospitalized/patient-year; p < 0.05). CONCLUSIONS Findings of this real-world, retrospective cohort study confirm prior reports indicating that hybrid surgery is a safe and effective intervention for multilevel spinal disease which demonstrates non-inferiority in relation to the current gold standard mACDF. The use of administrative claims data in this analysis provides a unique perspective allowing the inclusion of a larger, more generalizable population has historically been reported on in small cohort studies.
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Affiliation(s)
- Kee D Kim
- UC Davis Health, 4860 Y Street Suite, Sacramento, CA, 3740, 95817, USA
| | - Domagoj Coric
- Atrium Musculoskeletal Institute, Spine Division, Carolina Neurosurgery and Spine Associates, 225 Baldwin Avenue Charlotte, Charlotte, NC, 28204, USA
| | - Armen Khachatryan
- Orthopedic Spine Surgery, The Disc Replacement Center, 3584 West 9000 South #209, Salt Lake City, UT, 84088, USA
| | | | | | - Mike McCormack
- Zimmer Biomet, 1800 W Center Street, Warsaw, IN, 46580, USA
| | | | - Richard Ditto
- Zimmer Biomet, 1800 W Center Street, Warsaw, IN, 46580, USA
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Udeze C, Evans KA, Yang Y, Lillehaugen T, Manjelievskaia J, Mujumdar U, Li N, Andemariam B. Economic and clinical burden of managing transfusion-dependent β-thalassemia in the United States. J Med Econ 2023; 26:924-932. [PMID: 37432699 DOI: 10.1080/13696998.2023.2235928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/12/2023]
Abstract
AIMS To describe clinical complications, treatment use, healthcare resource utilization (HCRU), and costs among patients with transfusion-dependent β-thalassemia (TDT) in the United States. MATERIALS AND METHODS Merative MarketScan Databases were used to identify patients with β-thalassemia between 1 March 2010, and 1 March 2019. Patients were eligible for inclusion with ≥1 inpatient claim or ≥2 outpatient claims for β-thalassemia and ≥8 red blood cell transfusions (RBCTs) during any 12-month period after and including the date of the first qualifying β-thalassemia diagnosis code. Matched controls consisted of individuals without β-thalassemia. Clinical and economic outcomes of patients were assessed during ≥12 months of follow-up, defined as the period from the index date (i.e. the first RBCT) to either the end of continuous enrollment in benefits, inpatient death, or 1 March 2020. RESULTS Overall, 207 patients with TDT and 1035 matched controls were identified. Most patients received iron chelation therapy (ICT) (91.3%), with a mean of 12.1 (standard deviation [SD] = 10.3) ICT claims per-patient-per-year (PPPY). Many also received RBCTs, with a mean of 14.2 (SD = 4.7) RBCTs PPPY. TDT was associated with higher annual ($137,125) and lifetime ($7.1 million) healthcare costs vs. matched controls ($4183 and $235,000, respectively). Annual costs were driven by ICT (52.1%) and RBCT use (23.6%). Patients with TDT had 7-times more total outpatient visits/encounters, 3-times more prescriptions, and 33-times higher total annual costs than matched controls. LIMITATIONS This analysis may underestimate the burden of TDT, as indirect healthcare costs (e.g. absenteeism, presenteeism, etc.) were not included. Results may not be generalizable to patients excluded from this analysis, including those with other types of insurance or without insurance. CONCLUSIONS Patients with TDT have high HCRU and direct healthcare costs. Treatments that eliminate the need for RBCTs could reduce the clinical and economic burden of managing TDT.
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Affiliation(s)
- Chuka Udeze
- Health Economics and Outcomes Research, Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Kristin A Evans
- Real World Data Research & Analytics, Merative, Cambridge, MA, USA
| | - Yoojung Yang
- Health Economics and Outcomes Research, Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | | | - Urvi Mujumdar
- Health Economics and Outcomes Research, Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Nanxin Li
- Health Economics and Outcomes Research, Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Biree Andemariam
- Division of Hematology-Oncology, University of Connecticut Health, Farmington, CT, USA
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Abstract
In the context of concerns about the appropriateness and costs to insurers and patients of laboratory testing, this study uses data from the IBM MarketScan Commercial Claims and Encounters Database to examine out-of-network laboratory test spending, utilization, and prices in the US in 2008-2016.
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Affiliation(s)
- Zirui Song
- Harvard Medical School, Boston, Massachusetts
| | - Timothy Lillehaugen
- Harvard Medical School, Boston, Massachusetts
- now with IBM Watson Health, Cambridge, Massachusetts
| | - Jacob Wallace
- Yale School of Public Health, New Haven, Connecticut
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