title: Burden of illness, annual healthcare utilization, and costs associated with commercially insured patients with Cushing disease in the United States.
abstract: OBJECTIVE
  To describe the burden of illness, healthcare utilization, and costs associated with Cushing disease (CD), a rare disorder resulting from adrenocorticotropic hormone-secreting pituitary tumors, in commercially insured patients in the U. S.
  
  
  METHODS
  Patients with CD were identified in 2010 in the IMS Health PharMetrics and Truven Health Analytics MarketScan claims databases. Because there is no diagnosis code for CD, patients were identified with a claim for Cushing syndrome and either benign pituitary adenoma or hypophysectomy. We estimated total and CD-related utilization and costs using pharmacy and medical claims.
  
  
  RESULTS
  We identified 685 CD patients (81% female; mean age, 41.7 years; mean Charlson comorbidity index, 1.6; mean number of chronic conditions, 4.2); 30.5% of the patients had diabetes, 22.5% had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease/stroke, 5.5% had kidney stones, and 0.7% had compression fracture of a vertebra. Patients had a mean of 19.8 office visits per year; 38.4% had inpatient hospitalizations and 34.2% visited the emergency department (ED). Patients had a mean of 3.2 CD-related office visits per year; 26.9% had CD-related hospitalizations, 0.9% had CD-related ED visits, and 36.8% had CD treatments. Mean annual total costs were $34,992 (pharmacy, $3,597; medical costs, $31,395). CD-related costs accounted for $14,310 of total costs (CD treatment costs, $9,353; other CD-related costs, $4,957).
  
  
  CONCLUSIONS
  CD patients have a high burden of illness. Among CD patients in this study, 30.5% had diabetes, 22.5% had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease/stroke, and 5.5% had kidney stones. Patients had 19.8 office visits per year, and >34% of patients were hospitalized. Mean total cost of care was approximately $35,000 per year.
authors.affiliation: Partnership for Health Analytic Research, LLC, Beverly Hills, California.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Broder
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Neary
authors.affiliation: Partnership for Health Analytic Research, LLC, Beverly Hills, California.
authors.forename: Eunice
authors.initials: E
authors.lastname: Chang
authors.affiliation: Partnership for Health Analytic Research, LLC, Beverly Hills, California.
authors.forename: Dasha
authors.initials: D
authors.lastname: Cherepanov
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.
authors.forename: William H
authors.initials: WH
authors.lastname: Ludlam
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000191:economics* / Q000628:therapy