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Abstract: FR-PO378

Health Plan Coverage Duration and Annualized Healthcare Costs in Patients with ADPKD in a Managed Care Population

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Sanon, Myrlene, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Stellhorn, Robert A., Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Michalopoulos, Efstathios N., Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland, United States
  • Pao, Christina, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Oberdhan, Dorothee, Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland, United States
Background

ADPKD is a rare inherited systemic disease characterized by progressive kidney enlargement and worsening of kidney function leading to end stage renal disease, and transplant. Hypertension occurs in 70% of patients and contributes to disease progression, and cardiovascular morbidity and mortality. Even for long-term progressive diseases, US health plans often focus on short-term outcomes rather than prevention due to patients’ short retention in health plans. This study assesses health plan retention rates and direct healthcare costs of ADPKD patients with hypertension.

Methods

Patients diagnosed with ADPKD were selected from the Optum Clinformatics 2007-2017 US research database. ADPKD was identified using ICD9/10 codes: 753.12, 753.13, Q61.2, and Q61.3. Patients were required to have continuous medical and pharmacy benefits for 6 months pre- index date (baseline period) and ≥6 months post-index date. The index date was the date of ADPKD diagnosis. Duration of plan coverage was reported for the overall population and annual healthcare costs reported in patients with and without hypertension.

Results

A total of 9,361 patients met inclusion criteria, of whom 85% had hypertension. Mean enrollment duration was 36.5 months with a median of 28.1 months. Forty-three percent of patients had 1-2 years coverage, 18% 2-3 years coverage, 12% 3-4 years coverage, 8% 4-5 years coverage, and 18% greater than 5 years coverage. Mean annual direct healthcare costs were higher for patients with ADPKD and hypertension ($50,850) compared with ADPKD only ($16,135), p<0.001. In patients with ADPKD and hypertension, outpatient costs were the primary source of costs with a mean of $18,025, followed by inpatient costs ($15,957), pharmacy costs ($8,022), emergency room visits ($1,476), office visits ($993), and home health costs ($504).

Conclusion

The study findings indicate that most patients with ADPKD retain their health plan coverage for a relatively long period, including those with the most prevalent comorbid condition in this population. Direct healthcare costs were higher among patients with comorbid hypertension. Since these patients incur higher healthcare cost, health plans and decision makers may benefit from earlier disease management strategies for ADPKD.

Funding

  • Commercial Support