title: Treatment Patterns and Economic Burden in Patients Treated for Acromegaly in the USA.
abstract: BACKGROUND
  Acromegaly is a rare, debilitating condition for which data on the associated treatment patterns and economic burden are limited.
  
  
  OBJECTIVE
  Our objective was to examine patient characteristics, treatment patterns, and healthcare resource utilization (HRU)/costs for individuals with acromegaly treated with surgical and/or medical therapy in the USA.
  
  
  METHODS
  Using a large US claims database, adults with new episodes of acromegaly between 1 July 2007 and 31 December 2010 were identified (the first observed diagnosis being the index date). Patients had 6-month pre-index and 12-month post-index continuous enrollment and surgical and/or medical treatment during the 12-month post-index period. Descriptive analysis was performed to observe demographic/clinical characteristics, treatment patterns, HRU, and monthly healthcare costs between two mutually exclusive surgically and medically treated cohorts.
  
  
  RESULTS
  This study included 228 acromegalic individuals treated with surgical therapy and 169 treated with medical therapy. During the 12-month follow-up, compared with the medical cohort, the surgical cohort were more likely to have hypertension (50.4 vs. 32.0 %), sleep apnea (31.6 vs. 15.8 %), cardiac dysrhythmia (16.7 vs. 7.0 %), hospitalizations (98.3 vs. 13.6 %), and emergency room visits (29.8 vs. 20.7 %), and had more outpatient visits (10.2 vs. 5.2) and physician office visits (21.2 vs. 15.0) (all differences, p < 0.05). The surgical cohort had lower monthly healthcare costs during the 6-month pre-index period ($US1963.5 vs. 2818.4) but higher costs in the 12-month post-index period ($US5202.6 vs. 3076.5) than the medical cohort.
  
  
  CONCLUSIONS
  Our findings suggest the treatment pathway observed in this patient population has a non-negligible association with the clinical and economic burden.
authors.affiliation: Evidera, 430 Bedford Street, Suite 300, Lexington, MA, 02420, USA.
authors.forename: Chien-Chia
authors.initials: CC
authors.lastname: Chuang
authors.affiliation: Evidera, 430 Bedford Street, Suite 300, Lexington, MA, 02420, USA. sharvari.bhurke@evidera.com.
authors.forename: Sharvari
authors.initials: S
authors.lastname: Bhurke
authors.affiliation: Evidera, 430 Bedford Street, Suite 300, Lexington, MA, 02420, USA.
authors.forename: Shih-Yin
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Ipsen Pharma SAS, Boulogne-Billancourt, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Dinet
authors.affiliation: Ipsen Pharma SAS, Boulogne-Billancourt, France.
authors.forename: Siham
authors.initials: S
authors.lastname: Brulais
authors.affiliation: Ipsen Pharma SAS, Boulogne-Billancourt, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Gabriel