Real-world patient characteristics and utilization patterns in patients with cholangiocarcinoma who received pemigatinib in the United States of America.

Myasthenia gravis (MG) is a rare neuromuscular disorder with an estimated prevalence of 37 per 100,000 individuals in the United States. Despite patients with MG using a wide range of health care services, there is a lack of information regarding health care costs and health care resource utilization (HCRU). To gain insight into the health care cost and HCRU associated with an MG diagnosis from the US payer perspective. Patients with MG, defined by at least 2 claims for MG diagnoses, were identified from a commercial and Medicare claims database between 2016 and 2021. Controls who were never diagnosed with MG were matched at a 10:1 ratio with each patient with MG based on baseline demographic and clinical characteristics. The primary outcomes were 1-year total health care costs associated with MG diagnosis, and the secondary outcomes were 1-year HCRU associated with MG diagnosis. Difference-in-difference estimates from a multivariable linear regression model were used to report adjusted health care costs and HCRU. The final analytic cohort included 3,700 patients with MG and 37,000 controls. On average, patients were aged 54years, with 60% being female. The difference-in-difference estimates of the total health care cost for MG diagnosis in commercial and Medicare patients were $25,799 and $4,927, respectively (P < 0.01). MG diagnosis had significant impacts on HCRU across all health care settings. We quantified a significant increase in health care costs and HCRU in the first year following diagnosis of MG compared with the matched cohort. Future studies can further investigate long-term health care costs associated with patients with MG.

Purpose: To evaluate the impact of age on healthcare costs and resource utilization in pts with CD. Methods: A retrospective analysis, using the PharMetrics database, of pts with a dx of CD (ICD-9 code 555.x) from Jan. 1, 2000 through June 30, 2005 was conducted. Pts had to be continuously enrolled for 6 months pre-and 12 months post-CD dx, and have 2 distinct claims for CD. Mean/pt healthcare resource utilization and costs were calculated for pts in the yr following their initial CD dx. Outcomes are presented for all pts with CD, and by the following age grps: pediatric <18 yrs, adults 18 to 64 yrs, and pts ≥ 65 yrs. Results: The cohort consisted of 13454 CD pts. Over half of the pts were females and the mean age was 42 yrs. Mean annual total healthcare costs for all pediatric CD pts were $16700. The mean healthcare costs were highest among pediatric and pts ≥ 65 with CD ($19347 and $19900). Inpt hospitalization costs had the largest component of the mean annual total cost for all pts followed by drug, and outpt costs. Resource utilization was highest for pts ≥ 65 yrs. Conclusions: There is limited data assessing the healthcare costs and resource utilization in pts with CD by age group. Healthcare costs among this pt population are high. Pediatric pts and pts ≥ 65 yrs had higher mean healthcare costs than adults 18 to 64 yrs, primarily driven by inpt hospitalizations. New therapies that can reduce hospitalizations have the potential to decrease overall cost of care for CD pts.Table: Mean Healthcare Costs and Resource Utilization.

BackgroundWe aimed to describe healthcare resource utilization (HCRU) and healthcare costs in patients with newly confirmed lupus nephritis (LN) in the United States over a 5-year follow-up period.MethodsThis retrospective, longitudinal cohort study (GSK Study 214102) utilized administrative claims data to identify individuals with a newly confirmed diagnosis of LN between August 01, 2011, and July 31, 2018, based on LN-specific International Classification of Diseases diagnosis codes. Index was the date of first LN-related diagnosis code claim. HCRU, healthcare costs, and incidence of systemic lupus erythematosus (SLE) flares were reported annually among eligible patients with at least 5 years continuous enrollment post-index.ResultsOf 2,159 patients with a newly confirmed diagnosis of LN meeting inclusion and exclusion criteria, 335 had at least 5 years continuous enrollment post-index. HCRU was greatest in the first year post-LN diagnosis across all categories (inpatient admission, emergency room [ER] visits, ambulatory visits, and pharmacy use), and trended lower, though remained substantial, in the 5-year follow-up period. Among patients with LN and HCRU, the mean (standard deviation [SD]) number of ER visits and inpatient admissions were 3.7 (4.6) and 1.8 (1.5), respectively, in Year 1, which generally remained stable in Years 2–5; the mean (SD) number of ambulatory visits and pharmacy fills were 35.8 (25.1) and 62.9 (43.8), respectively, in Year 1, and remained similar for Years 2–5. Most patients (≥ 91.6%) had ≥ 1 SLE flare in each of the 5 years of follow-up. The proportion of patients who experienced a severe SLE flare was higher in Year 1 (31.6%) than subsequent years (14.3–18.5%). Total costs (medical and pharmacy; mean [SD]) were higher in Year 1 ($44,205 [71,532]) than subsequent years ($29,444 [52,310]–$32,222 [58,216]), driven mainly by inpatient admissions (Year 1: $21,181 [58,886]; subsequent years: $7,406 [23,331]–$9,389 [29,283]).ConclusionsPatients with a newly confirmed diagnosis of LN have substantial HCRU and healthcare costs, particularly in the year post-diagnosis, largely driven by inpatient costs. This highlights the need for improved disease management to prevent renal damage, improve patient outcomes, and reduce costs among patients with renal involvement.

Non-Adherence to Imatinib in Chronic Myeloid Leukemia Patients Is Associated with a Short Term and Long Term Negative Impact On Healthcare Utilization and Costs.

Patients with polycythemia vera (PV) are at increased risk of thromboembolic events (TEs), which are key contributors to reduced overall survival compared with the age- and sex-matched general population. In addition to aspirin and phlebotomy to maintain hematocrit level < 45%, many patients receive cytoreduction with hydroxyurea (HU), which is associated with improved survival and may reduce the risk of cardiovascular events and TEs. However, 1 in 4 patients become resistant to or intolerant of HU. In the general population, prophylaxis and treatment following arterial and venous thromboses are associated with increased health care resource utilization and costs. To describe the health care resource utilization and costs associated with TEs in patients with PV treated with HU in the United States. This retrospective cross-sectional analysis of the Truven Health Analytics MarketScan Research Databases included adult patients with a PV diagnosis who were newly treated with HU and continuously enrolled in medical and pharmacy benefit plans for ≥ 12 months pre- and post-index. HU treatment administration, persistence, adherence, and related adverse events, as well as TEs, were reported during the 12-month follow-up period. HU treatment patterns were further analyzed in a subgroup analysis comparing patients with and without a ≥ 45-day gap in HU treatment. Health care resource utilization and costs were analyzed in a subgroup analysis comparing patients who had TEs in the 12-month follow-up period with those who did not. Tests for statistically significant differences across the comparison groups were conducted, including chi-square tests for categorical variables and t-tests for continuous variables. The records of 1,322 patients with PV were included in this study. Mean age was 66.0 years; 51.3% were men; and 14.0% had a history of TEs. During the first year of HU treatment, 764 (57.8%) patients had a treatment gap of ≥ 45 days; however, treatment adherence was similar between those with and those without a gap (85.2% vs. 90.7%, respectively). TEs occurred in 216 (16.3%) patients within 12 months of HU initiation. Health care resource utilization was higher for patients with TEs versus those without, including the proportion of patients requiring inpatient services (50.9% vs. 18.4%; P < 0.001) and emergency room visits (48.1% vs. 26.3%; P < 0.001) and the mean number of inpatient admissions (1.7 vs. 1.3; P = 0.004); office visits (18.9 vs. 14.1; P < 0.001); and prescriptions (45.8 vs. 36.2; P<0.001). In addition, total mean health care costs ($45,040 vs. $16,438; P < 0.001); inpatient costs ($18,952 vs. $4,794; P < 0.001); outpatient costs ($20,844 vs. $8,046; P < 0.001); and outpatient pharmacy costs ($5,244 vs. $3,598; P = 0.002) were higher among patients with TEs than those without. Patients with PV receiving treatment with HU remain at risk for TEs. The occurrence of TEs during the 12-month follow-up in this patient population was associated with higher health care resource utilization and costs. This study was funded by Incyte Corporation. Parasuraman and Paranagama are employees and stockholders of Incyte Corporation. Shi and Bonafede are employees of Truven Health Analytics, which was awarded a research contract to conduct this study with and on behalf of Incyte Corporation. Study concept and design were contributed by all of the authors, who also interpreted the data and wrote and revised the manuscript. Bonafede and Shi collected the data. This study was presented as an abstract at the Academy of Managed Care Pharmacy NEXUS Annual Meeting on October 26-29, 2015, in Orlando, Florida.

Among patients with IgA nephropathy (IgAN), proteinuria and decline in kidney function may be associated with increased economic burden. This study aimed to provide current information on the epidemiology and economic burden of IgAN in the United States. Retrospective cohort study. Overall, 9,984 patients in the Optum's Market Clarity database identified by the presence of at least 2 natural language processing-derived IgAN signs and disease and symptoms terms; 813 with linked claims data included in a health care resource utilization/cost subcohort. High-risk proteinuria (≥1g/d), chronic kidney disease (CKD) stage. Standardized prevalence, health care resource utilization, costs. Descriptive statistics for categorical and continuous variables. Direct standardization for prevalence estimation. Generalized linear models for health care resource utilization/costs, reported as per-patient-per-month (PPPM) costs in 2020 US dollars. The estimated standardized US prevalence of IgAN (2016-2020) was 329.0 per 1,000,000 persons. High-risk proteinuria (≥1 vs<1 g/d) was associated with a higher mean PPPM number of outpatient visits (3.49 vs 1.74; P=0.01) and pharmacy claims (3.79 vs 2.41; P=0.01), contributing to higher mean total costs PPPM ($3,732 vs $1,457; P=0.01). Furthermore, higher CKD stage was also associated with higher health care resource utilization (number of outpatient visits PPPM, number of pharmacy claims PPPM, proportion of patients with inpatient visits and emergency department visits; P<0.001) and mean total cost PPPM (from $2,111 CKD stage 1 to $10,703 CKD stage 5/kidney failure; P<0.001). Generalizability outside of the catchment group for the database, missing data/errors inherent in retrospective database studies, relatively small sample size, use of Optum Market Clarity standardized pricing algorithms, exclusion of out-of-pocket costs. Health care resource utilization and costs were higher for IgAN patients with high-risk proteinuria and worsening kidney function. Treatments that reduce proteinuria and slow CKD disease progression may reduce the economic burden associated with IgAN. Immunoglobulin A nephropathy (IgAN) is a rare kidney disease. Over time, the kidneys may leak protein into the urine (proteinuria). IgAN can lead to kidney failure. Because IgAN is rare, it is hard to know how many people have it. This study used electronic health records to estimate the number of patients with IgAN in the United States, describe the characteristics of patients, and understand their treatments and the costs. The number of patients with IgAN increased between 2016 and 2020. The researchers think this is because doctors learned more about IgAN. Patients with severe disease used more health care resources and had higher costs. The authors believe treatments that slow kidney damage may reduce the cost of treating IgAN.

Bladder cancer is a common cancer with significant morbidity, mortality, and economic cost. Muscle-invasive bladder cancer (MIBC) is typically managed with radical cystectomy (RC). Despite its curative intent, a considerable proportion of patients experience recurrence after RC. The economic impact of recurrence among patients with surgically resected MIBC has not been described. To assess health care resource utilization (HCRU) and costs among patients with surgically resected MIBC in the United States, including the impact of disease recurrence. In this retrospective, observational study, the Surveillance, Epidemiology, and End Results-Medicare database (2007-2020) was used to identify patients diagnosed with T2-T4aN0M0 or T1-T4aN1M0 MIBC who underwent RC in the United States. Index date was the date of RC. Patients were stratified by whether they experienced recurrence following surgical resection. The index date for patients with recurrence was defined as 30 days prior to recurrence, and for patients without recurrence, the index date was drawn from a distribution to match the time window between surgical resection and the index date in the recurrence cohort. Patients were followed from the index date until the end of data availability, continuous enrollment, or death. Rates of HCRU per patient per year (PPPY) and mean health care costs per patient per month (PPPM; in 2022 USD) were summarized and compared between cohorts. A total of 1,149 patients met selection criteria. Patients had a median of 2.6years of follow-up. Demographic and clinical characteristics were generally similar between patients with (n = 503) and without recurrence (n = 602), with few exceptions. Patients with recurrence (compared with those without) were more likely to have had stage IIIA disease (47.9% vs 32.7%) and a proxy for cisplatin contraindications (54.1% vs 47.5%, both P < 0.05), which included renal insufficiency, peripheral neuropathy, sensorineural hearing loss, or cardiac disease. Following index, patients with surgically resected MIBC had 3.5 all-cause inpatient admissions, 1.0 all-cause emergency department (ED) visits, and 25.8 all-cause outpatient visits PPPY. Patients with recurrence had higher rates of all-cause HCRU than patients without recurrence after index, including inpatient admissions (adjusted incidence rate ratio: 2.4), ED visits (2.7), and outpatient visits (2.0; all P < 0.001). The total all-cause medical costs PPPM were $11,250 and were higher for patients with vs without recurrence ($10,030 vs $3,343; adjusted cost difference: $7,191), largely because of higher inpatient admissions costs ($6,654 vs $2,102; adjusted cost difference: $4,542; both P < 0.001). Surgically resected MIBC was associated with a substantial economic burden with disease recurrence experiencing higher HCRU and health care costs. These findings underscore the need for novel and effective therapies that can prevent or delay disease recurrence for patients with MIBC.

BACKGROUND: Renal cell carcinoma (RCC) is associated with a high risk of recurrence. Although RCC has been shown to impose a substantial burden on patients, little is known about the incremental clinical and economic burden attributable to disease recurrence. With recent advances in the RCC-therapeutic landscape, including adjuvant therapies, it is important to quantify the clinical and economic burden associated with RCC recurrence to better evaluate the potential impact of treatment in this patient population. OBJECTIVE: To quantify the incremental clinical and economic burden associated with disease recurrence among patients with intermediate high-risk and high-risk RCC postnephrectomy. METHODS: Data from the Surveillance, Epidemiology, and End Results-Medicare database (2007-2016) were used to identify patients with newly diagnosed, intermediate high-risk or high-risk RCC following nephrectomy. Patients with a diagnosis of metastatic disease or repeat nephrectomy or initiating a systemic treatment for advanced RCC were grouped as the recurrence cohort; patients without evidence of recurrence were grouped as the cohort without recurrence. Health care resource utilization (HRU), health care costs (2019 US dollars), and overall survival (OS) were compared between cohorts with and without recurrence, adjusting for demographic and clinical characteristics. RESULTS: A total of 269 patients with recurrence and 374 patients without recurrence were analyzed. Mean age was 75.2 and 75.7 years (P = 0.383), respectively, and 64.7% and 57.8% (P = 0.076) of patients were male, respectively. Median follow-up duration was 17 and 28 months, respectively. Patients with recurrence had a significantly shorter OS relative to patients without recurrence (adjusted hazard ratio = 6.00; 95% CI = 4.24-8.48; P < 0.001). Additionally, compared with patients without recurrence, patients with recurrence had significantly more inpatient admissions (0.16 vs 0.04 admissions per person-month [PM]; adjusted incidence rate ratio [aIRR] = 3.88; 95% CI = 3.12-4.81), outpatient visits (3.06 vs 1.77 visits per PM; aIRR = 1.68; 95% CI = 1.56-1.81), emergency department visits (0.10 vs 0.05 visits per PM; aIRR = 2.11; 95% CI = 1.66-2.68), and days hospitalized (1.40 vs 0.35 days per PM; aIRR = 6.73; 95% CI = 4.95-9.15) per patient per month (all P < 0.001). Adjusted mean monthly health care costs per patient were significantly higher among patients with recurrence vs patients without recurrence (differences of all-cause total costs, total medical costs, and pharmacy cost per month: $6,320, $4,924, and $1,387; all P < 0.001). CONCLUSIONS: RCC recurrence is associated with a significant increase in mortality, HRU, and health care costs, highlighting the substantial unmet need in patients with intermediate high-risk and high-risk RCC postnephrectomy when adjuvant therapies are not widely available. DISCLOSURES: Dr Sundaram is an employee of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., and holds stock in AbbVie, Abbott, Johnson & Johnson, Bristol Myers Squibb, and Merck & Co., Inc. Dr Bhattacharya is an employee of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., and holds stock in Merck & Co., Inc. Dr Adejoro and Dr Rogerio were employees of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc. at the time of study conduct. Dr Adejoro holds stock in Johnson & Johnson. Dr Song, Dr Zhang, Mr Carley, and Dr Signorovitch are employees of Analysis Group, Inc., a consulting firm that received funding from Merck & Co., Inc. for the conduct of this research. Ms Zhu was an employee of Analysis Group, Inc. at the time of study conduct. Dr Haas is a Professor of Medicine at the Perelman School of Medicine, University of Pennsylvania and also serves on the advisory board for Aveo, Calithera and Exelixis, Co. Financial support for this study was provided by Merck & Co., Inc. The study sponsor was involved in the design and conduct of the study; collection, management, analysis, interpretation of data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Objectives Healthcare resource utilization (HCRU) and cost assessments for generalized myasthenia gravis (gMG) rarely include matched controls. HCRU and costs of acute MG-related events (MG exacerbation and myasthenic crisis) have been examined, but aggregation or comparison between studies is limited by heterogeneity. The study aim was to provide comprehensive, real-world data about gMG patients in the United States, including those experiencing MG-related events. A claims database analysis assessed (i) incremental HCRU and cost burden among adults with gMG versus non-gMG controls, (ii) occurrence of MG-related events, (iii) HCRU and cost burden of MG-related events, and (iv) factors associated with MG-related events. Methods In this retrospective cohort study, adults with gMG in the United States were identified from Optum’s de-identified Clinformatics® Data Mart Database (1 January 2017–31 March 2023). Rates of MG-related events during follow-up were calculated. Regression models assessed associations between occurrence of MG-related events and baseline demographic/clinical variables using a nested case–control design embedded within the existing gMG cohort. Incremental HCRU and healthcare costs were compared between cohorts with/without gMG using the propensity score method with inverse probability of treatment weighting for confounding controls. Incremental HCRU and healthcare costs were also reported for gMG subgroups with/without MG-related events. Results Analyses included 16,561 gMG patients (12,813 prevalent and 3748 incident) and 105,716 non-gMG controls. Among prevalent and incident gMG patients, respectively, MG exacerbation occurred during follow-up in 12.2 and 22.0% and myasthenic crisis in 6.0 and 12.4%. Patients with prior MG-related events were more likely to experience future events (odds ratio range 1.76–7.05). After weighting, gMG patients (median follow-up 696 days) experienced more frequent all-cause HCRU encounters and >4-fold higher healthcare costs ($5420 PPPM or ∼$65,000 per annum) versus non-gMG controls ($1298 PPPM or ∼$15,500 per annum). Among MG patients, those with MG exacerbation/myasthenic crisis, respectively, experienced means of 3.02/3.35 hospitalizations, 1.91/2.13 emergency department encounters, 12.70/13.39 skilled nursing facility encounters, and 67.86/75.52 outpatient encounters during follow-up; associated costs were $17,113/$18,640 PPPM (or ∼$205,000/$224,000 per annum). Conclusion The total healthcare cost of gMG was higher than some previous estimates at $5420 PPPM, driven primarily by inpatient care. MG exacerbation and myasthenic crisis occurred at a notable rate, could be recurrent, and were associated with high HCRU and costs. Findings can inform treatment decision-making with the aim of improving symptom control and reducing the likelihood of MG-related acute events.

IntroductionOvarian cancer (OC) is one of the leading causes of cancer mortality among women in the United States. With the approval of first-line maintenance therapies, patients with OC experienced prolonged first-line progression-free survival. While the literature addresses some costs associated with OC, further research is needed on the costs of progression that are potentially deferred or prevented by early maintenance. The objective of this study was to capture the health care resource utilization and costs of patients with advanced OC who never received poly(ADP ribose) polymerase (PARP) inhibitor maintenance.MethodsWe conducted a descriptive retrospective analysis of treatment patterns and the consequences of progression through several lines of therapy (LOTs) in patients with OC, using claims from commercial and Medicare Advantage health plan members in the United States from the Optum Research Database between January 1, 2010, and April 30, 2019. Patients were required to have an index OC diagnosis (≥ 2 non-diagnostic claims). We examined up to 4 LOTs and the time between treatments.ResultsA total of 5498 women met the eligibility criteria. As the number of LOTs increased, the median duration of each line decreased from 137 days in LOT1 to 94 days in LOT4, and the time between lines also decreased from 245 to 0 days. Ambulatory care visits were a major driver of health care resource utilization, with a median of about 6 monthly visits during active treatment. The mean total monthly health care costs for patients with at least 2 LOTs were US$8588 (SD: $8533) before LOT2 and increased to $15,358 (SD: $21,460) during or after LOT2.ConclusionsProlonging progression-free survival after first-line treatment in patients with OC may provide the opportunity to delay or prevent later treatment, the financial toxicity felt by patients, and the economic burden to the health care system associated with progression.

Real-World Patient Characteristics, Treatment Patterns, and Outcomes in Patients with Mantle Cell Lymphoma in China: A Retrospective Analysis Using a Real-World Database

Impact of Switching From an Initial Tumor Necrosis Factor Inhibitor on Health Care Resource Utilization and Costs Among Patients With Rheumatoid Arthritis

Objectives:Evaluate all-cause and endometriosis-related health care resource utilization and costs among newly diagnosed endometriosis patients with high-risk versus low-risk opioid use or patients with chronic versus non-chronic opioid use.Methods:A retrospective analysis of IBM MarketScan® Commercial Claims data from 2009 to 2018 was performed for females aged 18 to 49 with newly diagnosed endometriosis (International Classification of Diseases, Ninth Edition code: 617.xx; International Classification of Diseases, Tenth Edition code: N80.xx). Two sub-cohorts were identified: high-risk (⩾1 day with ⩾90 morphine milligram equivalents per day or ⩾1-day concomitant benzodiazepine use) or chronic opioid utilization (⩾90-day supply prescribed or ⩾10 opioid prescriptions). High-risk or chronic utilization was evaluated during the 12-month assessment period after the index date. Index date was the first opioid prescription within 12 months following endometriosis diagnosis. All outcomes were assessed over 12-month post-assessment period while adjusting for demographic and clinical characteristics.Results:Out of 61,019 patients identified, 18,239 had high-risk opioid use and 5001 chronic opioid use. Health care resource utilization drivers were outpatient visits and pharmacy fills, which were higher among high-risk versus low-risk patients (outpatient visits: 17.49 vs 15.51; pharmacy fills: 19.58 vs 16.88, p < 0.0001). Chronic opioid users had a higher number of outpatient visits (19.53 vs 15.00, p < 0.0001) and pharmacy fills (23.18 vs 16.43, p < 0.0001) compared to non-chronic opioid users. High-risk opioid users had significantly higher all-cause health care costs compared to low-risk opioid users (US$16,377 vs US$13,153; p < 0.0001). Chronic opioid users also had significantly higher all-cause health care costs compared to non-chronic opioid users (US$20,930 vs US$12,272; p < 0.0001). Similar patterns were observed among endometriosis-related HCRU, except pharmacy fills among high-risk and chronic sub-cohorts.Conclusion:This analysis demonstrates significantly higher all-cause and endometriosis-related health care resource utilization and total costs for high-risk opioid users compared to low-risk opioid users among newly diagnosed endometriosis patients over 1 year. Similar trends were observed for comparing chronic opioid users with non-chronic opioid users, except for endometriosis-related pharmacy fills and associated costs.

Endometriosis is a painful chronic inflammatory disease caused by endometrial tissue implanting and growing outside the uterus, resulting in pelvic pain symptoms and subfertility. Treatment imposes a substantial economic burden on the patient and health care system. To evaluate direct health care utilization and costs among women newly diagnosed with endometriosis compared with age-matched controls in a U.S. Medicaid population. This retrospective cohort study used deidentified health care claims from the 2007-2015 MarketScan Multi-State Medicaid Database. Women (aged 18-49 years) newly diagnosed with endometriosis (ICD-9-CM 617.xx) during January 2008 through September 2014 were identified (date of first diagnosis = index date). Age-matched women without endometriosis (controls) were selected from the database and assigned index dates matching the distribution for endometriosis patients. Direct health care resource utilization (HCRU) and costs (medical and pharmacy) over the 12-month post-index period (2015 U.S. dollars) were computed by service category (hospitalization, emergency room visits, outpatient services, and prescriptions) and compared between study cohorts using the chi-square test for proportions and t-test for continuous variables. The final sample included 15,615 endometriosis patients and 86,829 matched controls. HCRU during the 12-month post-index follow-up period was significantly higher for endometriosis cases compared with controls in all measured categories. Hospital admissions occurred among 33.1% of cases and 7.2% of controls, and 65.8% of endometriosis patients were admitted for endometriosis-related surgery. Emergency room visits occurred in 71.5% of cases, and 42.2% of controls. Mean (SD) office visits were 10.4 (8.5) for endometriosis patients and 5.1 (6.9) for controls. Endometriosis patients had significantly more prescription claims than controls, 45.9 (42.0) versus 25.1 (39.1). Mean total direct health care costs were $13,670 ($29,843) for cases versus $5,779 ($23,614) for controls. All differences between cases and controls were significant at P < 0.001. Health care costs and resource utilization in all measured categories were higher among endometriosis cases than controls. The economic burden of endometriosis among patients with Medicaid insurance is substantial, underscoring the unmet medical need for earlier diagnosis and cost-effective treatments. This study was funded by AbbVie and conducted by Truven Health Analytics, an IBM Company. AbbVie participated in developing the study design, data analysis and interpretation, manuscript writing and revisions, and approval for publication. Soliman and Vora are employees of AbbVie and may own AbbVie stock/stock options. Surrey has served in a consulting role on research to AbbVie and is on the speaker bureau for Ferring Laboratories. Bonafede and Nelson are employees of Truven Health Analytics, an IBM Company, which received compensation from AbbVie for the overall conduct of the study and preparation of the manuscript. Agarwal has served in a consulting role on research to AbbVie. Preliminary results of this study were previously presented in a podium session at the 2017 American Society for Reproductive Medicine Scientific Congress and Expo; October 28-November 1, 2017; San Antonio, TX.

To compare healthcare resource utilization and costs among patients with psoriasis, psoriatic arthritis (PsA), and a control group of patients without psoriasis and PsA in the USA. The IBM® MarketScan® Commercial Database was used to identify three adult patient groups from 1/1/2009 through 4/30/2020: (1) Psoriasis: ≥ 2 diagnoses ≥ 30 days apart for psoriasis (no PsA diagnoses); (2) PsA: ≥ 2 diagnoses for PsA; (3) Control: no psoriasis or PsA diagnoses in their entire claims records. Patients with comorbid rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, or ulcerative colitis were excluded from the analyses. Controls were matched 1:1 to psoriasis and PsA patients based on age, gender, index year, and number of non-rheumatological comorbidities. Healthcare resource utilization and costs (in 2019 USD) were evaluated descriptively and through mixed models for five years of follow-up. A total of 142,531 psoriasis and 21,428 PsA patients were matched to the control group (N = 163,959). Annual all-cause healthcare costs per patient were $7,470, $11,062, and $29,742 for the control, psoriasis, and PsA groups, respectively. All-cause healthcare costs increased over time and were significantly greater among PsA vs. psoriasis (p < 0.0001) and the control groups (p < 0.0001). Across all categories of healthcare resources, utilization was greatest among patients with PsA and lowest in the control group. Annual healthcare costs and resource utilization were significantly higher with PsA compared with psoriasis and the control group, confirming the substantial economic burden of PsA. The cost disparity between these patient groups highlights a continued unmet medical need. Key Points • Patients with PsA incurred significantly greater healthcare resource utilization and costs than patients with psoriasis and patients without psoriasis and PsA. • Significantly greater costs and healthcare resource utilization were also observed among patients with psoriasis compared with patients without psoriasis and PsA.