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Abstract: TH-PO138

Patients with Membranous Nephropathy (MN): A Real-World (RW) Clinical and Economic Analysis

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders


  • Nazareth, Tara A, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States
  • Kariburyo, Furaha, STATinMED Research, Ann Arbor, Michigan, United States
  • Kirkemo, Aaron, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States
  • Xie, Lin, STATinMED Research, Ann Arbor, Michigan, United States
  • Pavlova-Wolf, Anna, Mallinckrodt, Henderson, Texas, United States
  • Bartels-Peculis, Laura, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States
  • Vaidya, Neel, STATinMED Research, Ann Arbor, Michigan, United States
  • Sim, John J., None, Los Angeles, California, United States

MN is one of the most common causes of nephrotic syndrome (NS) in adults. Given varying clinical course and treatment response, where 1/3 of patients progress to end-stage renal disease, MN represents a high-risk population where management strategies can alter and improve outcomes (van den Brand et al., 2014). We describe RW outcomes in a prevalent MN cohort using US administrative healthcare claims data.


A retrospective analysis was conducted using Truven Marketscan®, among commercially-insured patients ≥ 18 years during 1/1/12-12/31/15. MN was identified using ≥2 MN diagnoses (Dx ICD-9-CM=581.1, 583.1; ICD-10-CM= N052, N062 and N072). The date of first Dx was designated the index date. Patients with Dx indicating secondary causes of NS were excluded. Patients were followed for 1 year post-index and evaluated with regards to demographics, clinical outcomes, all-cause healthcare resource utilization [HCRU: inpatient (IP), emergency room (ER), outpatient (OP), medications (Rx)], and all-cause costs using Dx, procedure and drug codes. Costs were assessed in patients enrolled in fee-for-service plans (FFS).


701 patients were identified [54.8% male, mean age=48.7 years, hematuria (7.6%), mean Charlson Comorbidity Index score=2.3, from South (37.5%) and North Central US (23.0%)]. 15.3% of patients had urinary tract infections, 3.9% pneumonia, and 1.1% septicemia. Treatment with dialysis and renal transplant occurred in 4.3%, and 1.1% of patients, respectively. 25.1% used the ER and 12.6% had IP stays; 20.0 mean Rx were dispensed. Among FFS patients (n=562), total and mean (SD) costs were $17.6 million and $31,412.3 ($97,654.3), respectively. 5% of patients (n=28) were responsible for 57.4% of costs or $10.1 million, for a mean (SD) cost per patient of $362,064.1 ($259,261.3); as a proportion of cost, OP and IP were responsible for 89.3%, while Rx and ER comprised 10.0% and <0.8%, respectively.


Our analysis characterizes 1-year RW outcomes among commercially-insured patients with MN, revealing a subset responsible for a large portion of costs incurred largely by IP and OP use. This group should be studied further to focus identification and treatment strategies. Burden of illness and costs over a longer–term horizon should be examined.


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