利用裁决索赔数据评估肝性脑病患者获得利福昔明的障碍

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Arun Jesudian, Patrick Gagnon-Sanschagrin, Jessica Maitland, Kana Yokoji, Annie Guérin, Zeev Heimanson, Aaron Samson, Olamide Olujohungbe, Brock Bumpass
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引用次数: 0

摘要

持续使用利福昔明550 mg(以下简称利福昔明)治疗肝性脑病(HE)患者的住院率较低;然而,可能存在准入障碍。本研究评估了美国HE患者在利福昔明获取方面的差距和治疗差距的影响,特别是那些因索赔被拒绝而导致的差距,对住院和医疗保健费用的影响。方法:使用IQVIA PharMetrics®Plus数据库与纵向访问和裁决数据(2015-2022)相关联,识别使用了≥1次付费利福昔明处方填充的成人HE。在首次观察到接受利福昔明治疗的12个月期间(指标日期)评估利福昔明治疗缺口。在指标日期后的6个月内,比较了第1队列之间的调整后的显性HE (OHE)住院次数和医疗费用,该队列没有因索赔拒绝而存在差距,并且有:在索引日期之后的一年中,1711名患者中有94.7%经历了治疗缺口,其中34.8%的患者从首次尝试接受利福昔明到首次支付索赔存在起始缺口(77.7%的起始缺口由于拒绝索赔),72.0%的患者在积极治疗期间存在获取缺口(14.8%的积极治疗缺口由于拒绝索赔)。与队列1 (n = 432;平均年龄56.3岁),队列2 (n = 679;平均年龄54.8岁)的OHE住院发生率为1.55倍[调整后的发病率比:1.55(95%可信区间:1.10-2.20)],每位患者每月的医疗相关费用多出1579美元(均为p)。结论:处方索赔拒绝经常导致利福昔明起始治疗的延迟和积极治疗期间获取利福昔明的差距。获得利福昔明的障碍与HE患者住院和医疗费用增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Access Barriers to Rifaximin Among Patients with Hepatic Encephalopathy Using Adjudicated Claims Data.

Introduction: Continuous treatment with rifaximin 550 mg (hereafter rifaximin) is associated with lower hospitalization rates in patients with hepatic encephalopathy (HE); however, access barriers may exist. This study assessed gaps in rifaximin access and the impact of treatment gaps, particularly those resulting from claim rejections, on hospitalizations and healthcare costs among patients with HE in the United States.

Methods: The IQVIA PharMetrics® Plus database linked with Longitudinal Access and Adjudicated Data (2015-2022) were used to identify adults with HE who had ≥ 1 paid rifaximin prescription fill. Rifaximin treatment gaps were assessed during the 12-month period from the first observed attempt at receiving rifaximin (index date). Adjusted number of overt HE (OHE) hospitalizations and healthcare costs were compared over the 6 months following the index date between Cohort 1, who had no gap due to claim rejection and had < 7 days of treatment gap due to other reasons, and Cohort 2, who had ≥ 1 rejection gap or had ≥ 7 days of non-rejection gap.

Results: During the year following the index date, 94.7% of the 1711 patients experienced a treatment gap, including 34.8% with initiation gaps from first attempt at receiving rifaximin to first paid claim (77.7% of initiation gaps due to rejected claims) and 72.0% with gaps in access during active treatment (14.8% of active treatment gaps due to rejected claims). Compared with Cohort 1 (n = 432; mean age 56.3 years), Cohort 2 (n = 679; mean age 54.8 years) had 1.55 times the incidence rate of OHE hospitalizations [adjusted incidence rate ratio: 1.55 (95% confidence interval: 1.10-2.20)] and incurred US$1579 more in healthcare-associated costs per-patient-per-month (all p < 0.05).

Conclusion: Prescription claim rejections frequently led to delays in rifaximin initiation and gaps in access during active treatment. Access barriers to rifaximin were associated with increased hospitalizations and healthcare costs in patients with HE.

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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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