A real-world analysis of the clinical and healthcare burden associated with osteogenesis imperfecta

Introduction

The healthcare resource utilization (HCRU) and cost burden of osteogenesis imperfecta (OI) in US clinical practice is currently unclear.

Methods

This real-world, retrospective study assessed patients with ≥1 inpatient claim or ≥ 2 outpatient claims with ICD-10 codes for OI using Optum's deidentified Clinformatics® Data Mart Database (Oct 1, 2015–Nov 30, 2023). Patients were required to have ≥24 months' continuous healthcare plan enrollment; index date was first claim with OI diagnosis code. Patients with OI were matched 1:5 with non-OI patients on age, sex, index date, and follow-up duration. Comorbidities, fractures, HCRU, and costs per person-year (PPY) were stratified by age (≤19 years, 20–54 years, ≥55 years). Continuous and categorical variables were compared using t-tests and chi-square tests, respectively. Generalized linear and logistic regression models were constructed for HCRU and costs.

Results

Overall, 1367 patients with OI (≤19 years, n = 324; 20–54 years, n = 521; ≥55 years, n = 522) were matched with 6835 non-OI controls. HCRU was more frequent in patients with OI versus controls; PPY inpatient admissions were 0.17 versus 0.05 (≤19 years), 0.20 versus 0.11 (20–54 years), and 0.32 versus 0.15 (≥55 years) (p < 0.01). OI patients had higher total healthcare costs than non-OI controls (≤19 years, $26,892 vs $10,134; 20–54 years, $27,673 vs $16,101; ≥55 years, $42,335 vs $25,143 PPY) (p < 0.01), driven by increased outpatient visits (pediatrics) and inpatient admissions (adults).

Conclusion

Substantial clinical and economic burden was observed in patients with OI in US clinical practice. These findings may inform evaluation of disease-modifying therapies.