PGI13 Economic Burden and Treatment Patterns of Adult Patients With Chronic Constipation Identified Through Retrospective Database Research

Abstract

ECONOMIC BURDEN AND TREATMENT PATTERNS OF ADULT PATIENTS WITH CHRONIC CONSTIPATION IDENTIFIED THROUGH RETROSPECTIVE DATABASE RESEARCH Lofroth E1, Bruce Wirta S1, Hodgkins P2, Bloomfield E3, Kerstens R4, Joseph A5 1IMS Health, Stockholm, Sweden, 2Shire Pharmaceuticals LLC, Wayne, PA, USA, 3IMS Health, London, UK, 4Shire-Movetis NV, Turnhout, Belgium, 5Shire Switzerland, Eysins, Switzerland OBJECTIVES: To collect real-world data on the economic burden and treatment patterns associated with chronic constipation in Swedish patients through retrospective database research. METHODS: A regional Swedish database was used that combines diagnostic and health care data with prescription drug use and mortality data from national registers. The drug register comprises all dispensations made at pharmacies, defined as dispatches. According to Swedish legislation, a dispatch can last for up to 90 days, which is common for chronic diseases. Adults with chronic constipation ( 2 primary constipation diagnoses, or one primary constipation diagnosis and two associated laxative dispatches, over 12 months) were selected during 2005-2008. Patients with irritable bowel syndrome (IBS) or opioidinduced constipation were excluded. Data were retrieved on: health care contacts and drug use for 12 months from the first constipation diagnosis; patient demographics; and comorbidities. RESULTS: Of the initial selection, 2119 patients were excluded owing to opioid use (32%) and 435 owing to IBS (7%). The final population comprised 4043 patients (60% women) with a mean age of 67 years (range: 18-106 years). A history of arrhythmia or diabetes mellitus was common ( 10%), with prevalence increasing with age. During follow-up, patients had, on average, 2.3 constipation-related health care contacts and 15.2 additional health care contacts, at average annual costs of €1642 (standard deviation [SD]: €14 618) and €5944 (SD: €18 209), respectively. Most patients (54%) used 1 type of laxative during follow-up and 17% used 3 types. On average, patients had four laxative dispatches and 43 non-laxative dispatches, at average annual costs of €61 (SD: €74) and €624 (SD: €1137), respectively. CONCLUSIONS: Patients with chronic constipation were mainly elderly with high disease burden, as demonstrated through frequent health care contacts (17.5/year) and extensive drug use (47 dispatches/year). Constipationrelated care accounted for 22% of total resource utilization, while laxatives made up 10% of total drug costs.