Evaluation of Health Care Costs and Utilization Patterns for Patients With Gout

详细信息	查看全文 | 推荐本文 |

• 作者：Haesuk Park ; MPharm¹ ; Karen L. Rascati ; PhD¹ ; ^{krascati@mail.utexas.edu} ; Karim Prasla ; PharmD ; MS ; BCPS² ; Tyrone McBayne ; PharmD³
• 关键词：adherence ; gout ; gouty arthropathy ; health care costs ; retrospective studies ; serum uric acid
• 刊名：Clinical Therapeutics
• 出版年：2012
• 期刊代码：65_01492918
• 类别：med
• 出版时间：March, 2012
• 卷：34
• 期：3
• 页码：640-652
• 文件大小：462 K

摘要

Background

The prevalence of gout has been increasing. Serum uric acid (sUA) levels 鈮? mg/dL have been associated with high morbidity and increased health care utilization.

Objective

To assess the costs and patterns of health care resource utilization for patients with gout, categorized into 3 cohorts based on sUA levels.

Methods

We retrospectively analyzed laboratory, pharmacy, and medical service claims data (January 2005 to June 2010) for patients 鈮?8 years old. Inclusion criteria were at least 2 sUA levels and at least 1 primary gout diagnosis (International Classification of Disease-9th revision code 274.xx), and/or at least 1 prescription for gout-specific medications. Outcomes including costs, health care resource utilization, and medication adherence and persistence were assessed for the 1-year postindex period and summarized for the 3 cohorts based on sUA levels: <6 mg/dL, 6 to 8.99 mg/dL, and 鈮? mg/dL. Costs were adjusted based on preindex utilization and baseline characteristics.

Results

Three hundred fifty-two patients met the inclusion criteria: cohort 1 (sUA <6 mg/dL), n = 38, mean age 59 years; cohort 2 (sUA 6-8.99 mg/dL), n = 231, mean age 61 years; and cohort 3 (sUA 鈮? mg/dL), n = 83, mean age 62 years. Mean adjusted gout-related health care costs were $332, $353, and $663, respectively (P <0.05); mean adjusted all-cause health care costs were $11,365, $11,551, and $14,474, respectively, for the 3 cohorts (P <0.05). sUA levels were positively associated with the percent of patients who had at least 1 hospitalization and the mean number of hospitalizations and emergency department visits (P < 0.05). Significantly more patients with sUA <6 mg/dL achieved adherence rates of 鈮?0%and had a longer mean duration of continuous treatment compared with patients with sUA between 6 and 8.99 mg/dL or 鈮?.0 mg/dL (P <0.05).

Conclusions

Patients with high levels of sUA had higher gout-related and all-cause health care costs, more all-cause hospitalizations, and emergency department visits, but they also exhibited poorer adherence and persistence.