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Kidney Week

Abstract: PO1627

Clinical and Economic Impact of Primary Hyperoxaluria: A Retrospective Claims Analysis

Session Information

Category: Genetic Diseases of the Kidneys

  • 1002 Genetic Diseases of the Kidneys: Non-Cystic

Authors

  • Hoppe, Bernd, Dicerna Pharmaceuticals Inc, Cambridge, Massachusetts, United States
  • Silber, Abigail, Trinity Life Sciences, Waltham, Massachusetts, United States
  • Miyasato, Gavin, Trinity Life Sciences, Waltham, Massachusetts, United States
  • Koenig, Tom, Dicerna Pharmaceuticals Inc, Cambridge, Massachusetts, United States
  • Skaar, Jeffrey R., Trinity Life Sciences, Waltham, Massachusetts, United States
  • Langman, Craig B., Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
Background

Primary hyperoxalurias (PH; types 1, 2, and 3) are rare genetic disorders resulting in the overproduction of oxalate in the liver and that manifest in renal complications. This study sought to quantify the healthcare resource utilization (HCRU), costs, and clinical characteristics of PH patients.

Methods

This retrospective study analyzed claims from IQVIA PharMetrics® Plus (1/2014-12/2019). PH cohort inclusion was an ICD-10 code for PH (E72.53) and no evidence of secondary hyperoxaluria (SH). A random 5% sample from the same database of patients without PH or SH served as a control cohort (non-PH). Clinical outcomes, including kidney stones, costs, and HCRU were compared between the cohorts for a 12-month period. The Charlson Comorbidity Index (CCI) was used to characterize comorbidities.

Results

The annualized median and mean costs per patient for the PH cohort (n=325; median $10,385; mean $21,541) were significantly higher (p<0.001) than the non-PH cohort (n=2,579,352; median $1,079; mean $5,041). Costs were significantly higher for PH patients across age groups (see table) and care settings, including inpatient/outpatient settings (p<0.001). The majority of PH patient cost (62%) was associated with outpatient visits. The PH cohort saw significantly higher use of specialists compared to non-PH patients (p<0.001), including nephrologists (19% vs 1%) and urologists (66% vs 3%). Over one year, 80% of the PH cohort had at least one kidney stone. The CCI scores for the PH and non-PH cohorts were 0.79 and 0.22, respectively.

Conclusion

The median cost of care for the PH cohort was 10 times higher than the non-PH cohort over all age groups annually, and the PH cohort showed substantially greater HCRU compared to the non-PH cohort. Additional research is required to better understand these costs in an effort to enable more efficient healthcare utilization and improve care delivery to these at-risk patients.

 <18 years18-35 years36-55 years55+ years
 PHnon-PH PHnon-PH PHnon-PH PHnon-PH 
Sample Size20651,473 41725,871 138791,338 126410,670 
Average$27,100$2,981*$21,902$3,673*$17,602$5,793*$24,856$9,280*
Median$7,730$698*$8,951$810*$9,311$1,350*$13,413$2,496*

*Indicates p<0.001

Funding

  • Commercial Support