TY - JOUR
T1 - Direct costs of carcinoid syndrome diarrhea among adults in the United States
AU - Dasari, Arvind
AU - Halperin, Daniel M.
AU - Joish, Vijay N.
AU - Perez-Olle, Raul
AU - Dharba, Samyukta
AU - Balaji, Kavitha
N1 - Funding Information:
study was sponsored by Lexicon Pharmaceuticals, Inc., 8800 Technology Forest Place, The Woodlands, TX 77381, United States. Vijay N Joish, Samkyuta Dharba and Kavitha Balaji are employees of Lexicon Pharmaceuticals, Inc., and Raul Perez-Olle was an employee of Lexicon Pharmaceuticals, Inc. during the conduct of the study and development of the manuscript; they may own common stock or may have been granted stock options or other equity incentive awards. Arvind Dasari and Daniel M Halperin are employees of The University of Texas MD Anderson Cancer Center who received consulting fees from Lexicon Pharmaceuticals, Inc. for their participation and contributions to this study.
Funding Information:
This study was sponsored by Lexicon Pharmaceuticals, Inc. Medical writing support was provided by Jeff Frimpter, MPH, and Kristi Boehm, MS, ELS.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/12/21
Y1 - 2019/12/21
N2 - BACKGROUND The burden of carcinoid syndrome (CS) among patients with neuroendocrine tumors is substantial and has been shown to result in increased healthcare resource use and costs. The incremental burden of CS diarrhea (CSD) is less well understood, particularly among working age adults who make up a large proportion of the population of patients with CS. AIM To estimate the direct medical costs of CSD to a self-insured employer in the United States. METHODS CS patients with and without CSD were identified in the IBM® MarketScan® Database, including the Medicare Supplemental Coordination of Benefits database. Eligible patients had ≥ 1 medical claim for CS with continuous health plan enrollment for ≥ 12 mo prior to their first CS diagnosis and for ≥ 30 d after, no claims for acromegaly, and no clinical trial participation during the study period (2014-2016). Baseline demographic and clinical characteristics, including comorbidities and treatment, were analyzed using descriptive statistics. Measures of healthcare resource use and costs were compared between patients with and without CSD, including Emergency Department (ED) visits, hospital admissions and length of stay, physician office visits, outpatient services, and prescription claims, using univariate and multivariate analyses to evaluate associations of CSD with healthcare resource use and costs, controlling for baseline characteristics. RESULTS Overall, 6855 patients with CS were identified of which 4,043 were eligible for the analysis (1352 with CSD, 2691 with CS only). Baseline demographic and clinical characteristics were similar between groups with the exception of age, underlying tumor type, and health insurance plan. Patients with CSD were older, had more comorbidities, and received more somatostatin analog therapy at baseline. Patients with CSD required greater use of healthcare resources and incurred higher costs than their peers without CSD, including hospitalizations (44% vs 25%) and ED visits (55% vs 31%). The total adjusted annual healthcare costs per patient were 50% higher (+ $23865) among those with CSD, driven by outpatient services (+ 56%), prescriptions (+ 48%), ED visits (+ 26%), physician office visits (+ 21%), and hospital admissions (+ 11%). CONCLUSION The economic burden of CSD is greater than that of CS alone among insured working age adults in the United States, which may benefit from timely diagnosis and management.
AB - BACKGROUND The burden of carcinoid syndrome (CS) among patients with neuroendocrine tumors is substantial and has been shown to result in increased healthcare resource use and costs. The incremental burden of CS diarrhea (CSD) is less well understood, particularly among working age adults who make up a large proportion of the population of patients with CS. AIM To estimate the direct medical costs of CSD to a self-insured employer in the United States. METHODS CS patients with and without CSD were identified in the IBM® MarketScan® Database, including the Medicare Supplemental Coordination of Benefits database. Eligible patients had ≥ 1 medical claim for CS with continuous health plan enrollment for ≥ 12 mo prior to their first CS diagnosis and for ≥ 30 d after, no claims for acromegaly, and no clinical trial participation during the study period (2014-2016). Baseline demographic and clinical characteristics, including comorbidities and treatment, were analyzed using descriptive statistics. Measures of healthcare resource use and costs were compared between patients with and without CSD, including Emergency Department (ED) visits, hospital admissions and length of stay, physician office visits, outpatient services, and prescription claims, using univariate and multivariate analyses to evaluate associations of CSD with healthcare resource use and costs, controlling for baseline characteristics. RESULTS Overall, 6855 patients with CS were identified of which 4,043 were eligible for the analysis (1352 with CSD, 2691 with CS only). Baseline demographic and clinical characteristics were similar between groups with the exception of age, underlying tumor type, and health insurance plan. Patients with CSD were older, had more comorbidities, and received more somatostatin analog therapy at baseline. Patients with CSD required greater use of healthcare resources and incurred higher costs than their peers without CSD, including hospitalizations (44% vs 25%) and ED visits (55% vs 31%). The total adjusted annual healthcare costs per patient were 50% higher (+ $23865) among those with CSD, driven by outpatient services (+ 56%), prescriptions (+ 48%), ED visits (+ 26%), physician office visits (+ 21%), and hospital admissions (+ 11%). CONCLUSION The economic burden of CSD is greater than that of CS alone among insured working age adults in the United States, which may benefit from timely diagnosis and management.
KW - Carcinoid syndrome
KW - Carcinoid syndrome diarrhea
KW - Healthcare costs
KW - Neuroendocrine tumors
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U2 - 10.3748/wjg.v25.i47.6857
DO - 10.3748/wjg.v25.i47.6857
M3 - Article
C2 - 31885426
AN - SCOPUS:85077340968
SN - 1007-9327
VL - 25
SP - 6857
EP - 6865
JO - World journal of gastroenterology
JF - World journal of gastroenterology
IS - 47
ER -