Kidney Week

Abstract: TH-PO138

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

Session Information

• Clinical Glomerular Disorders: FSGS, MN, MCD
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Glomerular

• 1005 Clinical Glomerular Disorders

Authors

• Nazareth, Tara A, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States

Tara A Nazareth,

• Kariburyo, Furaha, STATinMED Research, Ann Arbor, Michigan, United States

Furaha Kariburyo,

• Kirkemo, Aaron, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States

Aaron Kirkemo,

• Xie, Lin, STATinMED Research, Ann Arbor, Michigan, United States

Lin Xie,

• Pavlova-Wolf, Anna, Mallinckrodt, Henderson, Texas, United States

Anna Pavlova-Wolf,

• Bartels-Peculis, Laura, Mallinckrodt Pharmaceuticals, Hampton, New Jersey, United States

Laura Bartels-Peculis,

• Vaidya, Neel, STATinMED Research, Ann Arbor, Michigan, United States

Neel Vaidya,

• Sim, John J., None, Los Angeles, California, United States

John J. Sim,

Background

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.

Methods

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).

Results

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.

Conclusion

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.

Funding

• Commercial Support