PMH24 - Healthcare Costs Associated with Hyperprolactinemia in the United States

Abstract

To assess the incremental healthcare costs associated with hyperprolactinemia among patients receiving antipsychotics. Commercially insured adults were identified from the Truven Commercial US claims database (2006Q1–2016Q3). For patients with hyperprolactinemia (hyperprolactinemia cohort), the index date was defined as 14 days before the first hyperprolactinemia indicator (hyperprolactinemia, amenorrhea, galactorrhea, gynaecomastia, hypogonadism, prolactin assay, mammary ductogram/galactogram). For patients without hyperprolactinemia (hyperprolactinemia-free cohort), the index date was selected so that patient characteristics at that date matched the characteristics of the matched patients in the hyperprolactinemia cohort (i.e., demographics, antipsychotic treatment history, comorbidities, and mental-health medical services). Both cohorts were treated with antipsychotics within 12 months before index date. Costs from a payers' perspective were compared between cohorts during the 6-month period following index date and were annualized. Analyses were replicated among Medicaid-insured patients. For each cohort, 499 patients were identified, mean age was 39 years, and 77% were female. Compared to the hyperprolactinemia-free cohort, the hyperprolactinemia cohort was associated with incremental total healthcare costs of $8,197 ($21,522 vs $13,325; p<0.01), and incremental medical costs of $6,124 ($14,549 vs $8,425; p<0.01), which were mainly driven by hyperprolactinemia-related ($3,933 vs $222; p<0.01) and mental health-related ($7,043 vs $3,495; p=0.01) costs, accounting for 61% and 58% (not mutually exclusive) of the medical costs difference, respectively. All-cause inpatient costs were an important contributor of the medical cost difference, representing 40% of difference between cohorts ($5,234 vs $2,807; p=0.03). Similar findings were observed in Medicaid-insured patients (N=257 in each cohort); the hyperprolactinemia cohort was associated with incremental total healthcare costs of $12,212 ($32,459 vs $20,246; p<0.01), and incremental medical costs of $10,782 ($22,757 vs $11,975; p<0.01) compared to the hyperprolactinemia-free cohort. Hyperprolactinemia is associated with important healthcare costs. Therapeutic options with low/no impact on prolactin levels may contribute to reduce the hyperprolactinemia burden.