Abstract: TH-PO168

Patients with Focal Segmental Glomerulosclerosis (FSGS): A Claims Analysis of Clinical and Economic Outcomes

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • 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
Background

FSGS is the leading cause of idiopathic nephrotic syndrome (NS) in the US, accounting for 35% of cases (Haas et al., 1997; Kitiyakara et al., 2004). Given the complexity of diagnosis and treatment, many patients with FSGS have renal insufficiency at clinical presentation. Within 10 years, >50% develop kidney failure; post-transplant, FSGS can recur in 30-40% of patients (MedlinePlus FSGS; NephCure FSGS fact sheet). We studied a prevalent cohort to quantify the burden of illness with FSGS.

Methods

Commercially-insured patients ≥18 years with ≥2 diagnoses of FSGS [Diagnosis (Dx) code ICD-9=582.1 or ICD-10: N031, N033, N020, N040] were identified from Truven Marketscan® US healthcare claims data during 1/1/12-12/31/15; the first Dx date was denoted the index date. Patients with claims for secondary causes of NS (Dx) were excluded. During 1 year follow-up, demographics and clinical characteristics, clinical health outcomes, and all-cause healthcare resource utilization [HCRU: emergency room (ER), inpatient (IP), outpatient (OP), and medications (Rx)] were assessed using diagnosis, procedure and drug codes. Costs attributable to HCRU were evaluated in all patients enrolled in fee-for-service plans (FFS), as well as in the top 5% specifically.

Results

1,187 patients were identified [59.0% male, mean age=45.1 years, with hematuria (17.7%), mean Charlson Comorbidity Index score=2.5, from South and North Central US (62.3%)]. 14.7% of patients had urinary tract infections, 4.6% pneumonia and 2.7% septicemia. 12.5% were placed on dialysis and 4.1% received a renal transplant. 29.0% of patients used the ER and 20.6% had IP stays. 21.9 mean Rx were dispensed. Among FFS patients (n=949), total and mean (SD) costs were $42.1 million and $44,397 ($102,481.8), respectively. 5% of patients (n=47) were responsible for 44.4% of total costs equaling $18.7 million, for a mean (SD) per patient cost of $397,973.8 ($219,457.3); OP, IP, Rx and ER represented 57.2%, 30.5%, 11.8%, and 0.5% of total costs, respectively.

Conclusion

Our study characterizes the 1-year burden of illness with FSGS and identifies a small group of patients incurring high cost, mostly via IP and OP use. Understanding this subset and their unmet needs, as well as their longer-term outcomes and costs, is a priority.

Funding

  • Commercial Support