Healthcare costs and utilization associated with muscle weakness diagnosis codes in patients with chronic obstructive pulmonary disease: a United States claims analysis |
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Authors: | Laurel Trantham Sean D Candrilli Victoria S Benson Divya Mohan David Neil |
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Institution: | 1. Health Economics, RTI Health Solutions, Research Triangle Park, NC, USA;2. Real World Evidence and Epidemiology, GlaxoSmithKline, West Drayton, Uxbridge, UK;3. Research and Development, GlaxoSmithKline, Collegeville, PA, USA;4. Value Evidence and Outcomes, GlaxoSmithKline, Collegeville, PA, USA |
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Abstract: | Aims: Muscle weakness (MW)-attributable healthcare resource utilization (HCRU) and costs in patients with chronic obstructive pulmonary disease (COPD) have not been well-characterized in US insurance claims databases. The primary objective of this study was to estimate HCRU in patients with evidence of COPD with and without MW diagnosis codes.Materials and methods: This retrospective analysis used the MarketScan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases. Between January 2007 and March 2016, we identified patients aged ≥40 years with diagnosis codes for COPD (≥1 emergency department or inpatient claim or ≥2 outpatient claims within 1 year). The cohort was divided into patients with and without ≥1?MW diagnosis code. Propensity score matching was used to generate pairs of patients with and without MW (1:1). Multivariable regression analyses were used to estimate adjusted incremental costs and utilization attributable to the presence of MW diagnosis codes among patients with COPD.Results: Of 427,131 patients who met the study inclusion criteria, 14% had evidence of MW. After matching, 107,420 unique patients remained equally distributed across MW status. Patients with MW diagnosis codes had greater predicted annual HCRU, $2,465 greater total predicted annual COPD-related costs, and $15,179 greater total all-cause costs than those without MW diagnosis codes. Overall, <1% of patients received COPD-related pulmonary rehabilitation services.Limitations: Study limitations include the potential for undercoding of MW and lack of information on severity of MW in claims data.Conclusion: The presence of MW diagnosis codes yielded higher HCRU in this COPD population and suggests that the burden of MW affects both all-cause and COPD-related care. However, utilization of pulmonary rehabilitation, a known effective treatment for MW, remains low. Future research should expand on our results by assessing data sources that allow for clinical confirmation of MW among patients with COPD. |
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Keywords: | COPD muscle weakness muscle dysfunction healthcare resource utilization cachexia economic burden pulmonary rehabilitation |
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