S1361 Healthcare Resource Use and Associated Costs in the Three Years Following the Initial Diagnosis of Diabetic or Idiopathic Gastroparesis: A Retrospective Claims Analysis

Abstract

INTRODUCTION: Diabetic gastroparesis (DG) and idiopathic gastroparesis (IG) are the two most common forms of gastroparesis (GP). Because of the limited treatment options, many patients (pts) have inadequate symptom control which may lead to increased healthcare resource use (HRU). This study aimed to quantify the economic burden in HRU and associated costs of DG/IG in the United States over the 3 years (yrs) after first GP diagnosis (dx). METHODS: Adults newly diagnosed with DG or IG were identified in Optum’s de-identified Clinformatics® Data Mart Database (Q1-2007 to Q1-2019). Pts were continuously enrolled for ≥1 yr before and ≥1 yr after their first GP dx (index date). For controls without GP dx, index dates were randomly selected. Pts with DG/IG were matched 1:1 to controls using a mixed approach of exact matching (i.e., age, sex, complete yrs of follow-up post-index) and propensity score matching (i.e., income, education, index yr, Charlson Comorbidity Index [CCI] comorbidities, diabetic complications [DG only]). All-cause HRU and direct healthcare costs per person-year (PPY) were compared between DG/IG cases and matched controls in the 3 yrs post index date. RESULTS: DG and IG cohorts included 18,015 and 14,305 pts (mean age: 62 and 54 yrs; 34% and 24% males), respectively. DG/IG pts had a high comorbidity burden at baseline (DG: 34% chronic pulmonary disease, 29% renal disease; IG: 28% chronic pulmonary disease). Demographics and CCI comorbidities were balanced between GP pts and controls (Table 1). DG/IG pts had significantly higher annual HRU compared to matched controls in the first 3 yrs post-index, with the highest gap observed in Yr 1 (Figure 1). Healthcare costs were also significantly higher for DG/IG pts vs. controls across all 3 yrs post-index (mean total cost differences PPY: DG Yr 1 $34,885, Yr 2 $28,071, Yr 3 $25,606; IG Yr 1 $23,176, Yr 2 $16,627, Yr 3 $14,396; see Figure 2 for Yr 1 cost breakdown by service setting). Patterns of disease burden did not change in a sensitivity analysis with additional adjustment for conditions associated with GP (e.g., anemia, anxiety disorder). CONCLUSION: This study showed a substantial economic burden of both DG and IG among adults, highest in the first yr after dx and persistent over 3 yrs. In the first yr after dx, DG and IG pts had healthcare costs approximately two-fold higher than for the matched controls, emphasizing the need for more effective treatments that may reduce the burden of illness.Table 1Figure 1Figure 2