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Jennifer E Thorne, Namita Tundia, Martha Skup, Dendy Macaulay, Cindy Revol, Jingdong Chao, Parvez Mulani, Andrew D Dick; Direct and Indirect Resource Use and Costs Associated With Non-Infectious Non-Anterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5320.
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Non-infectious uveitis (NIU) can cause visual impairment and as a result may incur an extensive economic burden to society. We assessed direct (medical service and prescription drug) and indirect (work loss) resource use and costs of privately insured US employees with non-anterior NIU and compared them to matched controls.
Employees 18-64 years old with ≥2 visits for non-anterior NIU (intermediate-, posterior- or pan-uveitis: ICD-9: 360.12, 362.12, 362.18, 363.0x, 363.10-13, 363.15, 363.2x, 364.24) from January 1, 1998 to March 31, 2012 were identified in the OptumHealth claims database. Employees had continuous eligibility ≥6 months before (baseline period) and 1 year after (study period) a randomly selected non-anterior NIU diagnosis (index date). Non-anterior NIU patients (cases) were matched 1:1 by sex, age, region and index date to controls without a diagnosis of uveitis. Direct resource use and costs associated with inpatient stays; emergency department (ED), outpatient and ophthalmologist/optometrist visits; and prescription drugs were calculated. Indirect resource use and costs associated with work loss resulting from disability and medically-related absenteeism also were calculated. All costs were adjusted to 2012 US dollars (USD). Direct/indirect resource use and costs incurred during the study period were compared between the 2 cohorts using Wilcoxon signed-rank or McNemar tests. Multivariate regression assessed key cost differences between cases and controls, adjusting for baseline characteristics.
705 cases and 705 matched controls met the selection criteria (mean age, 45 years; 62.6% men). Cases had a significantly (P<0.05) higher number of mean visits compared to controls: ED (0.4 vs 0.2) and outpatient (16.5 vs 7.6) visits during the study period. Cases also used more prescription drugs (7.8 vs 4.1) and had more mean disability (10.3 vs 4.6), medically related absenteeism (8.5 vs 3.8), and total work loss days (18.7 vs 8.4) than controls (all comparisons P<0.05). Total direct and indirect costs were higher in cases than in controls, both in unadjusted (Figures 1 and 2) and adjusted results.
Non-anterior NIU is associated with substantial direct and indirect costs. More effective therapies may reduce this economic burden.
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