Medical Costs Associated with High/Moderate/Low Likelihood of Adult Growth Hormone Deficiency: A Healthcare Claims Database Analysis.

Autor:	Yuen KCJ; Barrow Pituitary Center, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA., Blevins LS; Department of Neurosurgery, University of California, San Francisco, CA, USA., Clemmons DR; Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA., Faurby M; Global Evidence, Pricing and Access, Novo Nordisk A/S, Søborg, Denmark., Hoffman AR; Department of Medicine, Stanford University, Stanford, CA, USA., Kelepouris N; Department of Medical Affairs BioPharm, CMR, Novo Nordisk Inc., Plainsboro, NJ, USA., Kerr JM; Department of Endocrinology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA., Tarp JM; Global Evidence, Pricing and Access, Novo Nordisk A/S, Søborg, Denmark., Fleseriu M; Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health and Science University, Portland, OR, USA.
Jazyk:	angličtina
Zdroj:	ClinicoEconomics and outcomes research : CEOR [Clinicoecon Outcomes Res] 2024 Mar 08; Vol. 16, pp. 133-147. Date of Electronic Publication: 2024 Mar 08 (Print Publication: 2024).
DOI:	10.2147/CEOR.S445495
Abstrakt:	Purpose: Adult growth hormone deficiency (AGHD) is often underdiagnosed and undertreated, leading to costly comorbidities. Previously, we developed an algorithm to identify individuals in a commercially insured US population with high, moderate, or low likelihood of having AGHD. Here, we estimate and compare direct medical costs by likelihood level. Patients and Methods: Retrospective, observational analysis using the Truven Health MarketScan database to analyze direct medical costs relating to inpatient and outpatient claims, outpatient prescription claims, medication usage, clinical utilization records, and healthcare expenditures. Patients were categorized into groups based on algorithmically determined likelihoods of AGHD. Likelihood groups were further stratified by age and sex. Trajectories of annual costs (USD) by likelihood level were also investigated. Results: The study cohort comprised 135 million US adults (aged ≥18 years). Individuals ranked as high-likelihood AGHD had a greater burden of comorbid illness, including cardiovascular disease and diabetes, than those ranked moderate- or low-likelihood. Those in the high-likelihood group had greater mean total direct medical monthly costs ($1844.51 [95% confidence interval (CI): 1841.24;1847.78]) than those in the moderate- ($945.65 [95% CI: 945.26;946.04]) and low-likelihood groups ($459.10 [95% CI: 458.95;459.25]). Outpatient visits accounted for the majority of costs overall, although cost per visit was substantially lower than for inpatient services. Costs tended to increase with age and peaked around the time that individuals were assigned a level of AGHD likelihood. Total direct medical costs in individuals with a high likelihood of AGHD exceeded those for individuals with moderate or low likelihood. Conclusion: Understanding the trajectory of healthcare costs in AGHD may help rationalize allocation of healthcare resources. Competing Interests: KCJY has received research grants to the Barrow Neurological Institute from Ascendis, Crinetics, Corcept, Sparrow Pharmaceuticals, and Amryt; served as occasional advisory board member for Novo Nordisk, Ascendis, Ipsen, Amryt, Recordati, Xeris and Crinetics; served as occasional speaker for Novo Nordisk and Recordati. LSB and JMK have nothing to disclose. DRC has acted as a consultant for Novo Nordisk. MFa and JMT are employees and stockholders of Novo Nordisk. ARH has acted as consultant for Ascendis and Novo Nordisk. NK is an employee of Novo Nordisk; and holds stocks in Novo Nordisk and Pfizer. MFl has received research support for her institution from Ascendis; received occasional consulting honoraria from Ascendis, Novo Nordisk, and Pfizer, and is part of the Pituitary Society Board of Directors. (© 2024 Yuen et al.)
Databáze:	MEDLINE
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