Economic burden of growth hormone deficiency among adults who are at risk for and who have confirmed growth hormone deficiency using US real-world data.

IF 3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Medical Economics Pub Date : 2025-12-01 Epub Date: 2025-08-23 DOI:10.1080/13696998.2025.2548741
Andrew R Hoffman, Subhara Raveendran, Janna Manjelievskaia, Allison S Komirenko, Isabelle Winer, Jennifer Cheng, Jessamine P Winer-Jones, Machaon Bonafede, Paul Miner, Alden R Smith
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引用次数: 0

Abstract

Background: Underdiagnosis and the absence of a condition-specific diagnostic code have made the economic burden of adult growth hormone deficiency (AGHD) difficult to capture. This study measured all-cause and disease-specific healthcare utilization and costs of AGHD among individuals stratified by diagnosis status and receipt of growth hormone (GH) treatment.

Methods: Adults meeting ≥1 of the following criteria (1/1/2017-12/31/2021): diagnosis of hypopituitarism or related condition, ≥3 pituitary hormone deficiencies, ≥3 pituitary hormone treatments, or ≥1 GH prescription were identified in the Veradigm Network EHR linked to claims. Individuals were stratified by GH level on or before the earliest qualifying event: confirmed (GH < 3 ng/mL), at-risk (no test result), ruled-out (GH ≥ 3 ng/mL). Confirmed and at-risk individuals were segmented by GH treatment. An age and gender-matched control cohort without AGHD was identified. Healthcare utilization and costs were measured in the 12-month post-index period. Multivariable modeling compared all-cause and AGHD-related healthcare costs, excluding cost of GH, among diagnosis- or treatment status-stratified cohorts while adjusting for baseline characteristics.

Results: Among 54,310 individuals at risk for AGHD and 268 with confirmed AGHD, 3.1% and 9.7% received GH treatment, respectively. Study subjects were, on average, 50 years old and majority female. Adjusted all-cause healthcare costs were higher among at-risk individuals (cost ratio [95% confidence interval]: 2.37 [2.26-2.49]) and among confirmed individuals (2.11 [1.52-3.43]) compared to controls. Adjusted annual AGHD-related costs were lower among confirmed individuals compared to at-risk individuals (0.62 [0.52-0.76]) and among treated individuals compared to untreated individuals (0.55 [0.47-0.64]) for those initiating GH therapy.

Conclusions: All-cause healthcare costs were higher among individuals with confirmed AGHD or at risk for AGHD than among adults without GHD. After excluding the cost of GH therapy, lower adjusted AGHD-related costs were associated with both a confirmed AGHD diagnosis and receipt of GH treatment.

使用美国真实世界数据证实有生长激素缺乏症风险和已证实有生长激素缺乏症的成年人的经济负担
诊断不足和缺乏针对特定病症的诊断代码使得成人生长激素缺乏症(AGHD)的经济负担难以捕捉。本研究测量了按诊断状态和接受生长激素(GH)治疗分层的个体中AGHD的全因和疾病特异性医疗保健利用和成本。方法:在Veradigm网络EHR中,符合以下标准(2017年1月1日- 2021年12月31日)≥1项的成年人:垂体功能低下或相关疾病的诊断,≥3次垂体激素缺乏,≥3次垂体激素治疗,或≥1次GH处方。根据最早的排位性事件发生时或之前的生长激素水平对个体进行分层:确诊(生长激素< 3ng /mL)、危险(无检测结果)、排除(生长激素≥3ng /mL)。确诊和高危个体通过激素治疗进一步分层。确定了年龄和性别匹配的无AGHD对照队列。在指数日期之后的12个月内测量医疗保健利用率和成本。多变量模型比较了诊断或治疗状态分层队列中全因和aghd相关的医疗成本,不包括GH的成本,同时调整了基线特征。结果在54,310例AGHD高危患者和268例确诊AGHD患者中,分别有3.1%和9.7%的患者接受了生长激素治疗。研究对象的平均年龄为50岁,大多数为女性。与对照组相比,高危人群(成本比[95%置信区间]:2.37[2.26-2.49])和确诊人群(成本比2.11[1.52-3.43])调整后的全因医疗费用较高。经调整的年度aghd相关费用在已确诊个体中低于高危个体(0.62[0.52-0.76]),在接受GH治疗的个体中低于未接受GH治疗的个体(0.55[0.47-0.64])。结论:确诊AGHD或有AGHD风险的个体的全因医疗费用高于无AGHD的成年人。在排除生长激素治疗的费用后,较低的调整后的AGHD相关费用与确诊的AGHD诊断和接受生长激素治疗都相关。
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来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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