July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Healthcare Resource Use, Characteristics, and Predictors of High-Cost Patients with Non-Infectious Inflammatory Eye Disease (NIIED) In a Commercially-Insured US Population
Author Affiliations & Notes
  • Winnie Nelson
    Mallinckrodt Pharmaceuticals, Bedminster, New Jersey, United States
  • J. Brad Rice
    Analysis Group, Inc, Boston, Massachusetts, United States
  • Alan G. White
    Analysis Group, Inc, Boston, Massachusetts, United States
  • Andrea Lopez
    Analysis Group, Inc, Boston, Massachusetts, United States
  • Julie Reiff
    Analysis Group, Inc, Boston, Massachusetts, United States
  • Laura Bartels-Peculis
    Mallinckrodt Pharmaceuticals, Bedminster, New Jersey, United States
  • Gosia Ciepielewska
    Mallinckrodt Pharmaceuticals, Bedminster, New Jersey, United States
  • Flavio Lima
    Mallinckrodt Pharmaceuticals, Bedminster, New Jersey, United States
  • Thomas Arno Albini
    Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Winnie Nelson, Mallinckrodt Pharmaceuticals (E); J. Brad Rice, Mallinckrodt Pharmaceuticals (C); Alan White, Mallinckrodt Pharmaceuticals (C); Andrea Lopez, Mallinckrodt Pharmaceuticals (C); Julie Reiff, Mallinckrodt Pharmaceuticals (C); Laura Bartels-Peculis, Mallinckrodt Pharmaceuticals (E); Gosia Ciepielewska, Mallinckrodt Pharmaceuticals (E); Flavio Lima, Mallinckrodt Pharmaceuticals (E); Thomas Albini, Mallinckrodt Pharmaceuticals (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5223. doi:
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      Winnie Nelson, J. Brad Rice, Alan G. White, Andrea Lopez, Julie Reiff, Laura Bartels-Peculis, Gosia Ciepielewska, Flavio Lima, Thomas Arno Albini; Healthcare Resource Use, Characteristics, and Predictors of High-Cost Patients with Non-Infectious Inflammatory Eye Disease (NIIED) In a Commercially-Insured US Population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5223.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Prior literature has established that uveitis is associated with significant economic burden for US payers. This study compares healthcare resource use (HCRU) and characteristics of high-cost versus lower-cost patients with NIIED (uveitis and other intraocular inflammations). Among these characteristics, the analysis identifies predictors of high-cost patients.

Methods : Patients with a NIIED diagnosis between 2006 and 2015 were selected from a US insurance claims database and stratified into quintiles based on total healthcare costs incurred during a 12-month follow-up period. Patient demographics, clinical characteristics, and HCRU were compared. Logistic regression models were used to determine characteristics associated with being a high-cost patient with NIIED, defined as having annual total healthcare costs in the top 20%.

Results : High-cost (80th-100th percentile) NIIED patients incurred an average total healthcare cost of $63,850 (Figure 1), nearly 5.5 times that of patients in the fourth quintile (60th–80th percentile) and 120 times that of the first quintile (0-20th percentile). The top 20% of NIIED patients account for approximately 77% of the total all-cause healthcare costs, and the top 1 percentile incurred $369,505 during the follow-up period. The high-cost was driven by inpatient admissions, emergency department visits, and prescription drug use. The presence of certain baseline autoimmune conditions, including multiple sclerosis, Behçet’s syndrome, and relapsing polychondritis, are predictors of high-cost NIIED patients (Table 1). Furthermore, a prescription for biologic therapies, inpatient admission, prescription for immunosuppressive agents, or a surgically placed corticosteroid implant during the follow-up period greatly increase the odds of being a high-cost patient (Table 1).

Conclusions : A small segment of patients with NIIED consumed the majority of resources. This study identified several predictors based on patient characteristics and HCRU that may help inform the profile of NIIED patients with the highest healthcare needs.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure 1. Average Total Healthcare Costs Per-patient During the 12-Month Follow-up Period

Figure 1. Average Total Healthcare Costs Per-patient During the 12-Month Follow-up Period

 

Table 1. Selected Predictors of High-cost Patients

Table 1. Selected Predictors of High-cost Patients

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