PMS40 REAL-WORLD TREATMENT PATTERNS AND ECONOMIC BURDEN OF ROTATOR CUFF TEAR PATIENTS IN THE US

Abstract

This study examined treatment characteristics and associated economic burden of Rotator cuff tears (RCT). Patients aged ≥18 years with ≥1 inpatient or ≥2 outpatient RCT diagnosis ≥30 days apart were identified in 1/1/2013-6/30/2017 using the IBM Watson Health MarketScan® Commercial database (index date=first observed RCT diagnosis). All patients had 1-year pre-index and post-index periods. Patient characteristics, all-cause costs, RCT-related costs (plan paid and patient out-of-pocket), healthcare resource utilization (HRU), and rotator cuff repairs (RCR) were reported by RCT type (partial or complete tears). Among 102,488 RCT patients identified, 45.7% were partial tear (46,856) and 54.3% were complete tear RCT (55,632). Partial were younger (56.3 years) than complete RCT (60 years). Complete RCT had higher rates of hypertension (49%), hypercholesterolemia (11%) and diabetes (19%). Physical therapy (82%), opioid (77%), and non-opioid medication (51.0%) were the most common conservative treatments. Post-index opioid use was significantly higher for complete (82%) compared to partial RCT (71%). About 30% of partial progressed to complete tear status with an average time of 79 days. About half of RCT patients had an RCR procedure (37% partial RCT, 61% complete RCT). Average time to first RCR was shorter for complete (46 days) than partial RCT (62.5 days). Among patients with 12-month post-RCR eligibility, around 6.1% partial and 6.4% of complete RCT had repeat surgery. Complete RCT patients had an average total baseline (within 12 months pre-index) costs of $17,096 and post-index costs of $32,110. Similarly, partial thickness patients had baseline costs of $16,385 and post-index costs of $27,017. Complete RCT patients had higher RCT-related post-index total cost compared to partial RCT ($9,183 vs. $7,283, p<0.0001). Despite almost all RCT patients seeking conservative treatment, half of RCT diagnosed patients require surgical treatment eventually. High opioid use, HRU and costs highlight the importance of efficiently managing patients with RCT diagnosis