Browsing by Author "Du, J"

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Assessing the Economic Burden of Rheumatoid Arthritis Patients With Different Clinical Disease Activity Index Scores: a Probabilistic Matching Study
(2016) Kariburyo, F; Du, J; Xie, L; Başer, Onur
To evaluate the health care resource utilization and economic burdenof rheumatoid arthritis (RA) based on the Clinical Disease Activity Index(CDAI). Adult patients diagnosed with RA (International Classificationof Diseases, Ninth Revision, Clinical Modification code 714.xx) were identified froma large claims database and a RA registry from 2006-2015. Patients identified wereprobabilistically matched with a 1:1 ratio based on age, gender, state, and indexyear. The first RA diagnosis date was designated as the index date. Patients wererequired to have continuous health plan enrollment with medical and pharmacybenefits for 12 months post-index date (follow-up period). Patients were classifiedas having high (> 22), moderate (> 10 to ≤ 22), or low disease activity (> 2.8 to ≤ 10),or in remission (0 to ≤ 2.8) based on CDAI scores. All-cause and RA-related healthcare costs and utilization during the follow-up period were assessed. A total of 3,749 matched RA patients were identified, and 24.11%, 31.93%, and26.91% had high, moderate, and low disease activity, respectively, and 17.04% werein remission. RA patients were, on average, age 57 years, 76% were female, andmost resided in Washington (77%), with average all-cause total costs of $27,008and RA-related costs of $5,262 during the 12-month follow-up period. The averagenumber of office visits was higher for patients with high disease activity (12.31),followed by 11.79, 11.71, and 11.59 for patients with moderate disease activity, lowdisease activity, and for those in remission. Primary cost drivers were outpatientand pharmacy costs, resulting in total all-cause costs of $28,054, $27,285, $26,633,and $25,600, and total RA-related costs of $5,511, $5,280, $4,893, and $5,461 forpatients with high, moderate, and low disease activity, and for those in remission,respectively. RA patients with high disease activity, measured byCDAI score, have a substantial economic burden.
Demographic and Socioeconomic Characteristics That Impact Selection of Oral Anticoagulants Among Non-Valvular Atrial Fibrillation Patients
(2016) Keshishian, A; Du, J; Xie, L; Yuce H.; Başer, Onur
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Evaluation of the Burden of Opioid Abuse Among Us Veteran Patients
(2015) Başer, Onur; Ogbomo, A; Tan, H; Du, J; Xie L.
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Examining the Health Care Resource Utilization and Economic Burden Among Rheumatoid Arthritis Patients With Different Routine Assessment of Patient Index Data 3 Scores: a Probabilistic Matching Study
(2016) Kariburyo, F; Du, J; Xie, L; Başer, Onur
Objectives: To examine the health care resource utilization and economic burdenof rheumatoid arthritis (RA) using the Routine Assessment of Patient Index Data3 (RAPID3).
Pcn62 - Assessing the Economic Burden and Health Care Resource Utilizations of Us Medica Re Patients With Myeloproliferative Neoplasms
(2015) Keshishian, A; Du, J; Xie, L; Başer, Onur
OBJECTIVES: To examine the economic burden and health care resource utilization of myeloproliferative neoplasms (MPNs) in the U.S. Medicare population. METHODS: A retrospective data analysis was performed using the U.S.national Medicare claims from January 2008 through December 2012. MPN patientswere identified using International Classification of Disease 9th Revision ClinicalModification (ICD-9-CM) diagnosis codes 238.4, 238.71, 238.76 and 289.83. The diagnosis date was designated as the index date. A comparison cohort without a MPNdiagnosis was created for patients of the same age, region, gender, index year andbaseline Charlson Comorbidity Index score. A random index date was chosen forthe comparison cohort to reduce selection bias. Patients were required to havecontinuous medical and pharmacy benefits 1 year pre- and post-index date. Oneto-one propensity score matching (PSM) was performed to compare follow-uphealth care costs and utilizations between the cohorts, adjusting for demographicand clinical characteristics. RESULTS: Eligible patients (N=17,950) were identifiedfor the MPN and comparison cohorts. After 1:1 PSM, a total of 5,546 patients werematched from each cohort and baseline characteristics were well-balanced. MPNpatients had a higher percentage of health care resource utilizations, includingMedicare carrier (98.6% vs. 65.9%), Durable Medical Equipment (DME; 29.5% vs.14.4%), Home Health Agency (HHA; 12.4% vs. 5.0%), outpatient visits (76.6% vs.37.4%), inpatient hospitalizations (27.2% vs. 6.8%) and Skilled Nursing Facility (SNF;7.5% vs. 2.0%) visits than non-MPN patients. Patients diagnosed with MPNs alsoincurred significantly higher costs, including Medicare carrier ($3,872 vs. $1,283),DME ($266 vs. $91), HHA ($639 vs. $250), outpatient ($10,061 vs. $3,204), inpatient($5,449 vs. $1,054), pharmacy ($1,069 vs. $713) and total health care costs ($23,060vs. $7,076; p<0.0001). CONCLUSIONS: MPN patients had a higher burden of illnesscompared to non-MPN patients.
Pcn62 - Assessing the Economic Burden of Us Medicare Patients Diagnosed With Non-hodgkin's Lymphoma
(2015) Xie, L; Keshishian, A; Du, J; Başer, Onur
OBJECTIVES: To evaluate the health care resource utilization and economic burdenof non-Hodgkin’s lymphoma (NHL) in the U.S. Medicare population. METHODS:NHL patients were identified (International Classification of Diseases, 9th Revision,Clinical Modification [ICD-9-CM] diagnosis codes 200.xx and 202.xx) using nationalU.S. Medicare claims from January 1, 2009 through December 31, 2011. The first diagnosis date was designated as the index date for the NHL cohort. Control patients of thesame age, region, gender and index year were identified and matched to case patientsbased on baseline Charlson Comorbidity Index (CCI) scores, and were assigned a randomly chosen index date to minimize selection bias. Patients were required to havecontinuous medical and pharmacy benefits 1 year pre- and post-index date. Studyoutcomes, including health care costs and utilizations, were compared between thedisease and comparison cohorts using 1:1 propensity score matching (PSM). RESULTS:A total of 20,254 patients were included in the NHL and comparison cohorts. After1:1 PSM, 4,705 patients were matched from each cohort and baseline characteristicswere balanced. Patients diagnosed with NHL were more likely to utilize health careresources including Medicare carrier (99.0% vs. 70.5%), Durable Medical Equipment(DME, 28.1% vs. 17.7%), Home Health Agency (HHA, 11.4% vs. 4.8%), outpatient visits(80.2% vs. 41.0%), inpatient stays (25.7% vs. 7.4%) and Skilled Nursing Facility (SNF,4.8% vs. 1.7%) and hospice admissions (0.9% vs. 0.3%). Patients diagnosed with NHLalso incurred higher Medicare carrier ($10,603 vs. $1,522), DME ($264 vs. $120), HHA($531 vs. $270), outpatient ($30,013 vs. $4,268), inpatient ($5,762 vs. $1,167), SNF ($875vs. $307), hospice ($197 vs. $67), pharmacy ($1,050 vs. $785) and total costs ($49,296vs. $8,507; p<0.005). CONCLUSIONS: The economic burden and health care resourceutilizations were significantly higher for patients diagnosed with NHL compared topatients without NHL.
Pcv3 - a Descriptive Analysis of Patient Characteristics, Bleeding and Recurrence Risk Among U.s Veteran Patients Diagnosed With Venous Thromboembolism
(2015) Xie, L; Du, J; Kariburyo, M. Furaha; Başer, Onur
Objectives: Patient characteristics and bleeding and recurrence risk of venousthromboembolism (VTE) were assessed among patients in the Veterans HealthAdministration (VHA) population. Methods: Adult patients (?18 years) with VTE(International Classification of Diseases, 9th Revision, Clinical Modification codes:451-453, 671.3, 671.4 and 671.9 deep vein thrombosis [DVT]; 415.1, 673.2, 673.8 pulmonary embolism [PE]) were identified from the VHA Medical SAS datasets. Theindex date was defined as the first VTE diagnosis date between 01APR2006 and30SEP2012. Patients were required to have ?2 outpatient VTE diagnosis claimswithin 3 weeks and one inpatient stay with a VTE diagnosis, continuous healthplan enrollment for 6 months pre-index date and no VTE diagnosis (V12.51, V12.52)in the baseline period. Patient data were assessed until the earlier of death or endof the study period. Outcomes of interest included VTE recurrence, major bleedingand clinically-relevant non-major bleeding (CRNM). The incidence rate (per 100person-year) was calculated for VTE recurrence and bleeding outcomes. Results:Total 88,280 VTE patients were identified, of which 67.6% had DVT and 24.9% had PE.VTE patients were mean age 66 years, 95.9% were male and more often resided inthe Southern U.S. region (37%). The baseline Charlson comorbidity index score was3.3 and common comorbid conditions included hypertension (56.00%), respiratorydisease (34.3%) and heart disease (34.3%). Non-steroidal anti-inflammatory drugs(60.10%), antidepressants (33.00%) and anticoagulants (36.8%) were also frequentlyprescribed in the baseline period. During the follow-up period, 37.5% of VTE casesoccurred in outpatient settings and 62.50% occurred in inpatient settings. The incidence rate for VTE recurrence (20.7%) was 10.5 per 100 person-years, major bleeding (21.9%) was 10.9 per 100 person-years and CRNM (23.00%) was 12.1 per 100person-years. Conclusions: U.S. veteran patients diagnosed with VTE had frequent comorbid conditions and were at high-risk for bleeding and VTE recurrence.
Pih13 - Examining the Fracture-Related Cost Burden and Health Care Resource Utilization Post-Menopause in the Us Medicare Population
(2015) Xie, L; Keshishian, A; Du, J; Başer, Onur
Objectives: To examine the fracture-related cost burden and healthcareresource utilization among post-menopausal women in the U.S. Medicare population. Methods: Post-menopausal women were identified using InternationalClassification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosiscodes from the U.S. Medicare claims dataset from 01JAN2008 through 31DEC2012.The first fracture diagnosis date was designated as the index date. One year ofcontinuous health plan enrollment was required for all patients pre- and postindex date. A comparison group was created, identifying patients without fracturesof the same age, region, gender and index year and were matched to case patientsbased on baseline Charlson Comorbidity Index scores. A randomly chosen indexdate for the comparison group reduced selection bias. Healthcare costs and utilizations were compared using 1:1 propensity score matching (PSM). Results: Beforematching (n=182,124), patients with fractures were more likely to be white (92.6%vs. 85.8%), reside in the Northeast U.S. region (19.4% vs. 16.4%), and have diagnosis of depression (18.0% vs. 13.0%) and chronic obstructive pulmonary disease(26.3% vs. 23.3%). After 1:1 PSM, 65,549 patients were included in each cohort andbaseline characteristics were well-balanced. Significantly more post-menopausalwomen with fractures had inpatient admission (42.3% vs. 8.6%, p<0.0001), outpatient (80.3% vs. 48.7%, p<0.0001), home health agency (31.2% vs. 6.9%, p<0.0001)skilled nursing facility (SNF) (25.7% vs. 2.72%, p<0.0001) and hospice admission(1.4% vs. 1.0%, p<0.0001) claims. Higher healthcare resource utilization translated to higher costs for post-menopausal fracture patients, including inpatient($7,869 vs. $1,203, p<0.0001), outpatient ($1,928 vs. $622, p<0.0001), SNF ($5,980vs. $437, p<0.0001), hospice ($338 vs. $244, p<0.0001), pharmacy ($1,052 vs. $829,p<0.0001) and total costs ($23,097 vs. $5,247, p<0.0001), than for those in the comparison cohort. Conclusions: Post-menopausal women with fractures in theU.S. Medicare population had higher healthcare resource utilization and expenditures than those without fractures.
Pmh26 - Comparing Healthcare Resource Utilization and Costs Among Schizophrenic Patients Who Initiated Typical Vs. Atypical Long-Acting Injectables in the Us Veteran Population
(2015) Başer, Onur; Kariburyo, M. Furaha; Du, J; Xie, L
OBJECTIVES: To evaluate healthcare resource utilization and costs among schizophrenic patients who initiated typical and atypical long-acting injectables (LAIs) inthe U.S. veteran population. METHODS: Using the Veterans Health Administration(VHA) Medical SAS datasets, patients with ?1 pharmacy claim for LAIs were identified from 01OCT2005 through 30SEPT2012. The first LAI date was designated asthe index date. Patients were required to be age ?18 years, have continuous healthplan enrollment for 12 months pre-index date and a schizophrenia diagnosis(International Classification of Diseases, 9th Revision, Clinical Modification [ICD9-CM] code 295.xx) during the study period. Patient data was observed until theearlier date of death or the end of the study period, and patients were assigned totypical LAI (fluphenazine, haloperidol, perphenazine) or atypical LAI (aripiprazole,olanzapine, paliperidone, risperidone) antipsychotic cohorts. All-cause (follow-up)and psychiatric disorder-related healthcare resource utilization and costs wereassessed. Follow-up health care costs were adjusted to per-patient-per-month.The generalized linear model (GLM) was used to assess cost and utilization differences among the cohorts. RESULTS: A total of 4,796 patients were identified(Typical LAI cohort: N=1,941; Atypical LAI cohort: N=2,855). Typical LAI patientswere older (age 53.81 vs. 50.94 years, p<0.0001) and more likely to be black (34.47%vs. 28.27%, p<0.0001) than atypical LAI patients. After adjusting for baseline differences using GLM, more patients prescribed typical LAIs had all-cause emergencyroom [ER] visits (61.66% vs. 58.11%, p=0.024) and inpatient stays (63.11% vs. 59.00%, p=0.008) and psychiatric disorder-related ER visits (33.83% vs. 30.05%, p=0.011)than those prescribed atypical LAIs. However, typical LAI patients incurred lowerall-cause pharmacy ($197 vs. $433, p<0.001), total ($2,850 vs. $3,073, p=0.048) andpsychiatric disorder-related total costs ($1,615 vs. $1,624, p=0.908) than atypical LAIpatients. CONCLUSIONS: Although patients who initiated typical LAIs had highhealthcare resource utilization, their economic burden was lower compared to thosewho initiated atypical LAIs.