title: Healthcare resource utilization and work loss in dermatomyositis and polymyositis patients in a privately-insured US population.
abstract: Background Dermatomyositis and polymyositis (DM/PM) are inflammatory myopathies characterized by muscle inflammation/weakness. Patients with DM/PM have a reduced quality-of-life and are at an increased risk for several comorbidities. Studies have assessed the incidence and prevalence of DM/PM; however, no study has estimated the burden of the diseases in terms of both healthcare resource utilization (HCRU) and work loss incurred by patients. Objective To provide a comprehensive, current estimate of the annual HCRU and work loss in DM/PM patients in the US. Methods All patients (aged 18-64 years) with a first diagnosis of DM/PM between January 1, 1998 and March 31, 2014 ('index date') were selected from a de-identified privately-insured administrative claims database. DM/PM patients were required to have continuous health-plan enrollment 12 months prior to and following their index date. Propensity-score (1:1) matching of DM/PM patients with non-DM/PM controls was carried out based on a logistic regression of demographic characteristics, comorbidities, costs, and HCRU to control for these confounding factors. Burden of HCRU and work loss (disability days and medically-related absenteeism) were compared between the matched DM/PM and the non-DM/PM cohorts over the 12-month period after the index date ('outcome period'). Results Of the 2617 DM/PM patients that met sample selection criteria, 2587 (98.9%) were matched with a non-DM/PM control. During the outcome period, DM/PM patients had significantly increased HCRU across places of service, including 44% more inpatient admissions (3.6 vs 2.5, p < 0.001), increased visits with specialists such as rheumatologists, neurologists and physical therapists, and filled 4.7 more prescriptions (32.2 vs 27.5, p < 0.001) than matched control patients. The increased HCRU led to significantly more medically-related work loss among DM/PM patients than matched controls (p < 0.001). Conclusions DM/PM imposes a substantial increase in healthcare resource use and is associated with statistically significantly greater work loss in the first year following diagnosis.
authors: a Analysis Group, Inc. , Boston , MA , USA ;
authors: J
authors: J
authors: Bradford Rice
authors: a Analysis Group, Inc. , Boston , MA , USA ;
authors: Alan
authors: A
authors: White
authors: a Analysis Group, Inc. , Boston , MA , USA ;
authors: Andrea
authors: A
authors: Lopez
authors: a Analysis Group, Inc. , Boston , MA , USA ;
authors: Philip
authors: P
authors: Galebach
authors: b Mallinckrodt Pharmaceuticals , Hazelwood , MO , USA ;
authors: Patricia
authors: P
authors: Schepman
authors: c Xcenda, L.L.C., Palm Harbor , FL , USA.
authors: Breanna
authors: B
authors: Popelar
authors: b Mallinckrodt Pharmaceuticals , Hazelwood , MO , USA ;
authors: Michael
authors: M
authors: Philbin
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D017281:Cost of Illness; D003882:Dermatomyositis / Q000191:economics*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000191:economics*; D017149:Private Sector; D057216:Propensity Score; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Dermatomyositis; burden; payer burden; polymyositis