Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina.

Autor:	Esquenazi A; MossRehab Gait and Motion Analysis Laboratory, Elkins Park, PA, USA. aesquena@einstein.edu., Bloudek L; Curta, Inc., Seattle, WA, USA., Migliaccio-Walle K; Curta, Inc., Seattle, WA, USA., Oliveri D; Genesis Research, Hoboken, NJ, USA., Tung A; Allergan, an AbbVie Company, Chicago, IL, USA., Gillard P; Allergan, an AbbVie Company, Chicago, IL, USA., Verduzco-Gutierrez M; Long School of Medicine at UT Health, San Antonio, TX, USA.
Jazyk:	angličtina
Zdroj:	Journal of rehabilitation medicine [J Rehabil Med] 2023 Oct 30; Vol. 55, pp. jrm11626. Date of Electronic Publication: 2023 Oct 30.
DOI:	10.2340/jrm.v55.11626
Abstrakt:	Background: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce. Objective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management including onabotulinumtoxinA. Methods: This retrospective claims analysis of IBM MarketScan Commercial and Medicare Supplemental databases included adults with ≥ 1 onabotulinumtoxinA claim for post-stroke spasticity (1 January 2010 to 30 June 2018) and continuous enrolment for ≥ 12 months pre- and post-index (first onabotulinumtoxinA claim date). All-cause and spasticity-related healthcare resource utilization and costs were compared 12 months pre- and post-index (McNemar's χ2 test or paired t-test). A subgroup analysis assessed effect of stroke-to-index interval on costs. Results: Among 735 patients, mean (standard deviation) stroke-date-to-index-date interval was 284.5 (198.8) days. Decreases were observed post-index for mean all-cause outpatient (62.9 vs 60.5; p ≤ 0.05) and emergency department visits (1.1 vs 0.8; p ≤ 0.0001), and hospital admissions (1.5 vs 0.4; p ≤ 0.0001). Increase in prescription fills (43.0 vs 53.7) was seen post-index. Post-index decreases in all-cause (-66%) and spasticity-related (-51%) costs were driven by reduced inpatient care costs. Findings were consistent regardless of stroke-date-to-index-date interval. Conclusion: Significant reductions in healthcare resource utilization and costs were observed after 1 year of post-stroke spasticity management including onabotulinumtoxinA. Long-term studies are needed to establish causality.
Databáze:	MEDLINE
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