title: Incremental healthcare resource utilization and costs in US patients with Cushing's disease compared with diabetes mellitus and population controls.
abstract: OBJECTIVE
  Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs.
  
  
  METHODS
  Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs.
  
  
  RESULTS
  There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001).
  
  
  CONCLUSIONS
  CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.
authors.affiliation: Partnership for Health Analytic Research, LLC, 280 South Beverly Drive, Suite 404, Beverly Hills, CA, 90212, USA. mbroder@pharllc.com.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Broder
authors.affiliation: Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA.
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Neary
authors.affiliation: Partnership for Health Analytic Research, LLC, 280 South Beverly Drive, Suite 404, Beverly Hills, CA, 90212, USA.
authors.forename: Eunice
authors.initials: E
authors.lastname: Chang
authors.affiliation: Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Ludlam
mesh_terms: D000328:Adult; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D047748:Pituitary ACTH Hypersecretion / Q000191:economics*; D011155:Population Control
keywords: Cost analysis; Costs; Cushing disease; Cushing syndrome; Diabetes mellitus; Utilization
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