title: Healthcare utilization and costs in patients with tuberous sclerosiscomplex-related renal angiomyolipoma.
abstract: OBJECTIVE
  To quantify healthcare utilization and costs in patients with tuberous sclerosis complex (TSC) and renal angiomyolipoma (AML) in a matched cohort of patients without TSC or AML.
  
  
  METHODS
  Administrative data from the MarketScan Research Databases were used to select patients with TSC and renal AML during January 1, 2000-March 31, 2013 from the Commercial database and January 1, 2000-June 30, 2012 from the Medicaid database. Patients were required to have at least 30 days of follow-up from initiation into the study, and were followed until inpatient death, end of insurance coverage, or the end of study. Age, calendar year, and payer-matched controls that had no TSC and no AML were selected. All-cause annualized healthcare utilization and costs were calculated by service category.
  
  
  RESULTS
  A total of 218 patients under 18 years and 377 patients 18 years and older with TSC-renal AML were selected from the Commercial database, and matched to 654 and 1,131 controls, respectively. Thirty-eight patients under 18 years and 110 patients 18 years or older with TSC-renal AML were selected from the Medicaid database, and matched to 54 and 212 controls, respectively. Within the Commercial cohort, and across both age groups, TSC-renal AML patients utilized more healthcare services than their matched controls. Within the Medicaid cohort, in both age groups, utilization was higher in TSC-renal AML patients vs control patients for inpatient admissions, emergency room visits, physician office visits, and hospital-based outpatient visits. Across age groups and in both the Commercial and Medicaid cohorts, the annual average total costs were significantly higher in TSC-renal AML patients compared to control patients (p < 0.05 for all). Healthcare costs ranged from $29,240-$48,499 for TSC-renal AML patients and from $2,082-$10,864 for control patients.
  
  
  CONCLUSIONS
  Compared to controls, TSC-renal AML patients incurred substantially higher annual healthcare utilization and costs.
authors.affiliation: a Truven Health Analytics Inc. , an IBM Company, Cambridge , MA , USA.
authors.forename: Xue
authors.initials: X
authors.lastname: Song
authors.affiliation: b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Zhimei
authors.initials: Z
authors.lastname: Liu
authors.affiliation: a Truven Health Analytics Inc. , an IBM Company, Cambridge , MA , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cappell
authors.affiliation: a Truven Health Analytics Inc. , an IBM Company, Cambridge , MA , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gregory
authors.affiliation: b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Qayyim
authors.initials: Q
authors.lastname: Said
authors.affiliation: b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Prestifilippo
authors.affiliation: c NYU Langone Medical Center , New York , NY , USA.
authors.forename: Hearns
authors.initials: H
authors.lastname: Charles
authors.affiliation: d Urologic Physicians , Edina , MN , USA.
authors.forename: John
authors.initials: J
authors.lastname: Hulbert
authors.affiliation: e LeBonheur Children's Hospital and St. Jude Children's Research Hospital , Memphis , TN , USA.
authors.forename: John
authors.initials: J
authors.lastname: Bissler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000150:complications / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D007680:Kidney Neoplasms / Q000150:complications / Q000191:economics*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014402:Tuberous Sclerosis / Q000150:complications / Q000191:economics*; D014481:United States; D055815:Young Adult
keywords: Angiomyolipoma; Healthcare utilization and costs; Observational study; Tuberous sclerosis