Healthcare Resource Utilization and Costs of Newly Treated GERD Patients Initiating Therapy with Dexlansoprazole and Esomeprazole in the United States

Abstract

Purpose: To describe the healthcare resource utilization and costs of newly treated patients with gastroesophageal reflux disease (GERD) who are initiating treatment with dexlansoprazole (DEX) or esomeprazole (ESO). Methods: Adults with at least one prescription claim for DEX or ESO between 1/1/2009 and 12/31/2010 (index event), ≥12 months of pre- and post-index continuous health plan and pharmacy benefit enrollment, and a diagnosis of GERD on ≥1 inpatient or non-diagnostic outpatient medical claim (ICD-9-CM 530.10, 530.11, 530.12, 530.13, 530.19, 530.81,787.1x) in the pre- or post-index period were identified from the linked MarketScan and GE Centricity research databases. Patients with PPI or H2RA treatment in the pre-index period were excluded, as were those with an indication of pregnancy at any time during the study period. Total all-cause and GERD-related utilization and costs in the 12-month post-index period were calculated. Generalized linear modeling was used to estimate adjusted costs for the two groups, controlling for differences in demographic (i.e., age, sex, region) and clinical characteristics (e.g., pre-index comorbid burden, GERD diagnosis and GERD-related comorbidities, and index dose level). Results: 965 and 4,749 newly treated patients initiating therapy with DEX (age = 49.0±13.0; 67.2% female) and ESO (age = 50.7±13.4; 64.1% female), respectively, were identified. Patients treated with DEX had a lower mean Charlson Comorbidity Index score than patients treated with ESO (0.5±1.0 vs. 0.6±1.2; p<0.0129). Total unadjusted all-cause costs during the post-index period of patients treated with DEX ($14,501±$24,884) were significantly lower (p<0.0002) than those of patients treated with ESO ($16,931±$34,295). The adjusted total annual mean cost in the DEX group was $7,710 compared to $8,094 for the ESO group. Total GERD-attributable costs in the post-index period were also lower for patients treated with DEX ($1,086±$1,808) (p<0.0001) than for those treated with ESO ($1,225±$1,763). Adjusted GERD-attributable annual mean cost was $380 for patients treated with DEX vs $441 for those treated with ESO. Differences in total allcause costs between DEX and ESO groups can be attributed to differences in the costs of outpatient services ($8,876±$13,956 vs. $9,509±$17,564; p<0.0001) and outpatient pharmacy claims ($2,886±$3,990 vs. $3,370±6,732; p<0.0001), whereas the differences in GERD-related costs are largely attributable to differences in the costs of outpatient pharmacy claims ($613±$622 vs. $832±$847; p<0.0001). Conclusion: The one-year post-index healthcare costs of newly treated GERD patients initiating therapy with DEX were lower than those of patients initiating treatment with ESO. Disclosure - This research was funded by Takeda Pharmaceuticals International, Inc., which markets dexlansoprazole. Reema Mody - Employee of Takeda Pharmaceuticals International, Inc. Emily Durden, Lorena Lopez-Gonzalez, and David Smith - Research consultants to Takeda Pharmaceuticals International, Inc.