Economic Burden of Patients With Chronic Idiopathic Constipation in the USA Before and After Prucalopride Initiation

Paul Feuerstadt , Mei Lu , Emi Terasawa , Brian Terreri , Shawn Du , Selina Pi , Ben Westermeyer , Rajeev Ayyagari , Anthony Lembo , Baharak Moshiree , Mena Boules , Brooks D. Cash
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Abstract

Background and Aims

Chronic idiopathic constipation (CIC) is associated with substantial health care resource utilization (HCRU) and economic burden; however, real-world evidence on the impact of treatment initiation on HCRU and health care costs are limited. We evaluated HCRU and direct health care costs associated with prucalopride initiation in patients with CIC in the United States.

Methods

Data were collected between January 1, 2015, and June 30, 2020, from the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases for 690 adults with ≥ 1 prescription fill for prucalopride and ≥ 1 constipation-related diagnosis code. All-cause and constipation-related HCRU (outpatient, emergency room, and inpatient visits) for all patients, and pharmacy and medical health care costs for those aged 18–64 years were assessed 6 months before (baseline) and after (study period) prucalopride initiation. Subpopulations examined were patients with prior CIC medication use and males with CIC.

Results

Compared with baseline, the mean number of any constipation-related outpatient visits (2.26 vs 1.52; P < .001) and the proportions of patients with these visits (82.6% vs 58.8%; P < .001) significantly decreased after prucalopride initiation. In 564 patients, total constipation-related health care costs significantly increased from baseline during the study period (mean: $1497 vs $2332; P < .001), primarily driven by increased pharmacy costs after prucalopride initiation ($621 vs $1751; P < .001). Constipation-related medical costs significantly decreased during the study period ($876 vs $580; P < .001). Some constipation-related HCRU and health care costs decreased after prucalopride initiation in patients with prior CIC medication use and males.

Conclusion

In adults with CIC, constipation-related HCRU and medical costs decreased, while constipation-related health care costs and pharmacy costs increased 6 months after prucalopride initiation.
美国慢性特发性便秘患者在服用普卡洛必利前后的经济负担
背景与目的慢性特发性便秘(CIC)与卫生保健资源利用(HCRU)和经济负担有关;然而,关于开始治疗对HCRU和卫生保健费用影响的实际证据有限。我们评估了美国CIC患者开始使用普卡必利的HCRU和直接医疗成本。方法数据收集于2015年1月1日至2020年6月30日,来自IBM MarketScan商业索赔和遭遇以及医疗保险补充数据库,涉及690名成人,处方≥1个普卡必利,便秘相关诊断代码≥1个。所有患者的全因和与便秘相关的HCRU(门诊、急诊室和住院就诊),以及18-64岁患者的药房和医疗保健费用在开始服用普卡必利之前(基线)和之后(研究期)6个月进行评估。检查的亚群是既往使用CIC药物的患者和患有CIC的男性。结果与基线相比,与便秘相关的门诊就诊平均次数(2.26 vs 1.52;P & lt;.001),就诊的患者比例(82.6% vs 58.8%;P & lt;.001)普卡必利起始后显著降低。在564名患者中,与便秘相关的总医疗费用在研究期间显著高于基线(平均:1497美元vs 2332美元;P & lt;.001),主要是由于普卡必利起始后药房成本增加(621美元vs 1751美元;P & lt;措施)。在研究期间,与便秘相关的医疗费用显著下降(876美元vs 580美元;P & lt;措施)。一些便秘相关的HCRU和医疗保健费用下降普卡必利开始后,既往使用CIC药物的患者和男性。结论成人CIC患者在服用普卡必利6个月后,便秘相关的HCRU和医疗费用下降,而便秘相关的医疗费用和药房费用增加。
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来源期刊
Gastro hep advances
Gastro hep advances Gastroenterology
CiteScore
0.80
自引率
0.00%
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审稿时长
64 days
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