TY - JOUR
T1 - The healthcare resource utilization and costs of chronic lung allograft dysfunction following lung transplantation in patients with commercial insurance in the United States
AU - Sheshadri, Ajay
AU - Sacks, Naomi C.
AU - Healey, Bridget
AU - Cyr, Phil
AU - Boerner, Gerhard
AU - Huang, Howard J.
N1 - Funding Information:
PRECISIONheor received funding from Breath Therapeutics, a division of Zambon, for the research reported here.
Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Aims: Chronic lung allograft dysfunction (CLAD), a common complication of lung transplantation, is the leading cause of death for lung transplant recipients. While data on lung transplant costs are available, the impact of CLAD on healthcare resource use (HRU) and cost is not well understood. The primary objective was to quantify the HRU and costs of CLAD in the US using real-world data. Methods: A longitudinal retrospective analysis was performed of commercial claims data from the IQVIA PharMetrics Plus database for patients aged 18–64 who underwent lung transplantation between January 1, 2006 and September 30, 2018. Lung transplantation was identified using International Classification of Disease and Common Procedure Terminology procedure codes. Patients studied were observable for at least 12 months before and after transplantation. Patients who developed CLAD were identified using novel, diagnosis codes for incident lung disease at least one year following transplantation. Descriptive analyses were conducted to assess the study’s outcomes prior to and following a CLAD diagnosis. All-cause HRU and costs, the study’s primary outcomes, leading up to and following CLAD diagnosis were calculated. Results: Among 129 transplant patients who developed CLAD, healthcare costs were substantially higher in the year following diagnosis ($198,113), compared to the year leading to diagnosis ($85,276). Inpatient admissions were responsible for most costs in years 1 and 2 following diagnosis ($99,372 and $83,348 respectively). Drug costs were higher in the 12 months post-index, compared to the 12 months pre-index ($3,600 vs $2,527). Limitations: Claims data do not include clinical data, have limits determining loss of follow-up, and do not provide granularity to determine disease severity. Also, there is no ICD-10-CM code specific to CLAD or BOS. Conclusions: CLAD after lung transplant is associated with substantial HRU and costs. Further work is needed to develop interventions that reduce this impact.
AB - Aims: Chronic lung allograft dysfunction (CLAD), a common complication of lung transplantation, is the leading cause of death for lung transplant recipients. While data on lung transplant costs are available, the impact of CLAD on healthcare resource use (HRU) and cost is not well understood. The primary objective was to quantify the HRU and costs of CLAD in the US using real-world data. Methods: A longitudinal retrospective analysis was performed of commercial claims data from the IQVIA PharMetrics Plus database for patients aged 18–64 who underwent lung transplantation between January 1, 2006 and September 30, 2018. Lung transplantation was identified using International Classification of Disease and Common Procedure Terminology procedure codes. Patients studied were observable for at least 12 months before and after transplantation. Patients who developed CLAD were identified using novel, diagnosis codes for incident lung disease at least one year following transplantation. Descriptive analyses were conducted to assess the study’s outcomes prior to and following a CLAD diagnosis. All-cause HRU and costs, the study’s primary outcomes, leading up to and following CLAD diagnosis were calculated. Results: Among 129 transplant patients who developed CLAD, healthcare costs were substantially higher in the year following diagnosis ($198,113), compared to the year leading to diagnosis ($85,276). Inpatient admissions were responsible for most costs in years 1 and 2 following diagnosis ($99,372 and $83,348 respectively). Drug costs were higher in the 12 months post-index, compared to the 12 months pre-index ($3,600 vs $2,527). Limitations: Claims data do not include clinical data, have limits determining loss of follow-up, and do not provide granularity to determine disease severity. Also, there is no ICD-10-CM code specific to CLAD or BOS. Conclusions: CLAD after lung transplant is associated with substantial HRU and costs. Further work is needed to develop interventions that reduce this impact.
KW - bronchiolitis obliterans syndrome
KW - chronic lung allograft dysfunction
KW - healthcare resource utilization
KW - lung transplantation
KW - real world evidence
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U2 - 10.1080/13696998.2022.2071065
DO - 10.1080/13696998.2022.2071065
M3 - Article
C2 - 35502563
AN - SCOPUS:85130754166
SN - 1369-6998
VL - 25
SP - 650
EP - 659
JO - Journal of Medical Economics
JF - Journal of Medical Economics
IS - 1
ER -