Economic burden of inadequate symptom control among US commercially insured patients with irritable bowel syndrome with diarrhea |
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Authors: | Jessica L. Buono Kush Mathur Amelia J. Averitt David A. Andrae |
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Affiliation: | 1. Allergan plc, Jersey City, NJ, USA;2. Axtria Inc., Berkeley Heights, NJ, USA |
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Abstract: | Aims: To assess healthcare resource use and costs among irritable bowel syndrome (IBS) with diarrhea (IBS-D) patients with and without evidence of inadequate symptom control on current prescription therapies and estimate incremental all-cause costs associated with inadequate symptom control.Methods: IBS-D patients aged ≥18 years with ≥1 medical claim for IBS (ICD-9-CM 564.1x) and either ≥2 claims for diarrhea (ICD-9-CM 787.91, 564.5x), ≥1 claim for diarrhea plus ≥1 claim for abdominal pain (ICD-9-CM 789.0x), or ≥1 claim for diarrhea plus ≥1 pharmacy claim for a symptom-related prescription within 1 year of an IBS diagnosis were identified from the Truven Health MarketScan database. Inadequate symptom control, resource use, and costs were assessed up to 1 year following the index date. Inadequate symptom control included any of the following: (1) switch or (2) addition of new symptom-related therapy; (3) IBS-D-related inpatient or emergency room (ER) admission; (4) IBS-D-related medical procedure; (5) diagnosis of condition indicating treatment failure; or (6) use of a more aggressive prescription. Generalized linear models assessed incremental costs of inadequate symptom control.Results: Of 20,624 IBS-D patients (mean age?=?48.5 years; 77.8% female), 66.4% had evidence of inadequate symptom control. Compared to those without inadequate symptom control, patients with evidence of inadequate symptom control had significantly more hospitalizations (12.0% vs 6.0%), ER visits (37.1% vs 22.6%), use of outpatient services (73.0% vs 60.7%), physician office visits (mean 11.0 vs 8.1), and prescription fills (mean 40.0 vs 26.7) annually (all p?.01). Incremental costs associated with inadequate symptom control were $3,065 (2013?US dollars), and were driven by medical service costs ($2,391; 78%).Limitations: Study included US commercially insured patients only and inferred IBS-D status and inadequate symptom control from claims.Conclusions: Inadequate symptom control associated with available IBS-D therapies represents a significant economic burden for both payers and IBS-D patients. |
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Keywords: | Irritable bowel syndrome with diarrhea treatment symptom control economic burden healthcare resource use |
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