title: Economic burden of anemia in an insured population.
abstract: OBJECTIVE
  Anemia is a common hematological disorder characterized by reduced hemoglobin concentrations. Despite information on prevalence and associated outcomes, little is known about the impact of anemia on health care utilization and costs. This study examines anemia prevalence and associated medical costs and utilization, using administrative claims for adults newly diagnosed with anemia, including up to 12 months of follow-up.
  
  
  METHODS
  Patients predisposed to anemia, based on selected comorbid conditions (chronic kidney disease, human immunodeficiency virus, rheumatoid arthritis, inflammatory bowel disease, congestive heart failure, and solid-tumor cancers), were identified. Costs for anemic patients and a random sample of nonanemic patients with these conditions were compared. Associations were evaluated after adjustment for potential confounders using a regression model. Clinical care patterns were examined overall and by condition.
  
  
  RESULTS
  Anemia was observed in 3.5% (81,423) of approximately 2.3 million health plan members in 2000; 15% of anemic patients received an identified treatment, with transfusion being the most frequent intervention. Utilization and costs were significantly higher for anemic patients (P < 0.001). Average annualized per-patient costs were 14,535 US dollars for anemic patients (55% outpatient, 33% inpatient, 13% pharmacy), 54% higher than the 9,451 US dollars average cost for nonanemic patients (45% outpatient, 36% inpatient, 19% pharmacy). After adjustment for age, other comorbidities (e.g., chronic kidney disease and cancer), sex, and insurance type (indemnity, preferred provider organization/point of service, or health maintenance organization, in the Medstat MarketScan database), anemic patients had average costs that were more than twice the adjusted costs of nonanemic patients.
  
  
  CONCLUSIONS
  Medical costs for anemic patients are as much as twice those for nonanemic patients with the same comorbid conditions.
authors.affiliation: Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, 90095-6945, USA. ANissenson@mednet.ucla.edu
authors.forename: Allen R
authors.initials: AR
authors.lastname: Nissenson
authors.forename: Sally
authors.initials: S
authors.lastname: Wade
authors.forename: Tim
authors.initials: T
authors.lastname: Goodnough
authors.forename: Kevin
authors.initials: K
authors.lastname: Knight
authors.forename: Robert W
authors.initials: RW
authors.lastname: Dubois
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology