Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy
Background:. Our study aimed to compare real-world healthcare resource utilization (HRU) and healthcare cost (HC) of Medicare-insured patients (≥65 years old) with Dupuytren’s contracture (DC) treated with Clostridium histolyticum (collagenase) or fasciectomy. Methods:. DC patients treated with coll...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004480 |
| _version_ | 1817997850579042304 |
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| author | Vladimir Zah, DPhil Filip Stanicic, MSc Jane Ruby, PhD Djurdja Vukicevic, MD, PhD David Hurley, MD |
| author_facet | Vladimir Zah, DPhil Filip Stanicic, MSc Jane Ruby, PhD Djurdja Vukicevic, MD, PhD David Hurley, MD |
| author_sort | Vladimir Zah, DPhil |
| collection | DOAJ |
| description | Background:. Our study aimed to compare real-world healthcare resource utilization (HRU) and healthcare cost (HC) of Medicare-insured patients (≥65 years old) with Dupuytren’s contracture (DC) treated with Clostridium histolyticum (collagenase) or fasciectomy.
Methods:. DC patients treated with collagenase or fasciectomy between July 2011 and June 2017 were identified using the IBM MarketScan Medicare Supplemental Database. The index date was the date of the first procedure. Demographic characteristics were captured on the index date, and comorbidities were assessed during the 24-month preindex period. HRU and HC were analyzed throughout the 12-month postindex period. Patients were matched using propensity score weights. Gamma log-linked generalized linear models were used to evaluate HC drivers.
Results:. Out of 37,374 DC patients, 2911 received collagenase, while 6258 underwent fasciectomy. Postmatching, the total average annual HC was similar between collagenase and fasciectomy ($7271 versus $6220, P = 0.357). When HCs were stratified by the service provider, outpatient facility and physician office costs were lower in the collagenase cohort ($850 versus $1284, P = 0.047 and $546 versus $1001, P < 0.001). The costs of professional services were significantly higher than in the fasciectomy cohort due to the cost of collagenase injection ($1682 versus $629, P < 0.001). The HRU was similar between cohorts, except for more frequent outpatient facility visits in fasciectomy patients (12.3 versus 22.9, P < 0.001). Generalized linear model revealed Charlson comorbidity index, plan type, patients’ residence region, sleep disorder, and hyperlipidemia as significant predictors of total HC.
Conclusion:. This study found comparable total annual HC and HRU between collagenase- and fasciectomy-treated Medicare patients. |
| first_indexed | 2024-04-14T02:44:23Z |
| format | Article |
| id | doaj.art-2e9d2ea2fddb41af9253d4daf6f80645 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-14T02:44:23Z |
| publishDate | 2022-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-2e9d2ea2fddb41af9253d4daf6f806452022-12-22T02:16:37ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-08-01108e448010.1097/GOX.0000000000004480202208000-00011Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or FasciectomyVladimir Zah, DPhil0Filip Stanicic, MSc1Jane Ruby, PhD2Djurdja Vukicevic, MD, PhD3David Hurley, MD4From the * HOER Department, ZRx Outcomes Research Inc., Mississauga, Ontario, CanadaFrom the * HOER Department, ZRx Outcomes Research Inc., Mississauga, Ontario, Canada† Medical Department, Endo Pharmaceuticals Inc., Malvern, Pa.From the * HOER Department, ZRx Outcomes Research Inc., Mississauga, Ontario, Canada† Medical Department, Endo Pharmaceuticals Inc., Malvern, Pa.Background:. Our study aimed to compare real-world healthcare resource utilization (HRU) and healthcare cost (HC) of Medicare-insured patients (≥65 years old) with Dupuytren’s contracture (DC) treated with Clostridium histolyticum (collagenase) or fasciectomy. Methods:. DC patients treated with collagenase or fasciectomy between July 2011 and June 2017 were identified using the IBM MarketScan Medicare Supplemental Database. The index date was the date of the first procedure. Demographic characteristics were captured on the index date, and comorbidities were assessed during the 24-month preindex period. HRU and HC were analyzed throughout the 12-month postindex period. Patients were matched using propensity score weights. Gamma log-linked generalized linear models were used to evaluate HC drivers. Results:. Out of 37,374 DC patients, 2911 received collagenase, while 6258 underwent fasciectomy. Postmatching, the total average annual HC was similar between collagenase and fasciectomy ($7271 versus $6220, P = 0.357). When HCs were stratified by the service provider, outpatient facility and physician office costs were lower in the collagenase cohort ($850 versus $1284, P = 0.047 and $546 versus $1001, P < 0.001). The costs of professional services were significantly higher than in the fasciectomy cohort due to the cost of collagenase injection ($1682 versus $629, P < 0.001). The HRU was similar between cohorts, except for more frequent outpatient facility visits in fasciectomy patients (12.3 versus 22.9, P < 0.001). Generalized linear model revealed Charlson comorbidity index, plan type, patients’ residence region, sleep disorder, and hyperlipidemia as significant predictors of total HC. Conclusion:. This study found comparable total annual HC and HRU between collagenase- and fasciectomy-treated Medicare patients.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004480 |
| spellingShingle | Vladimir Zah, DPhil Filip Stanicic, MSc Jane Ruby, PhD Djurdja Vukicevic, MD, PhD David Hurley, MD Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy Plastic and Reconstructive Surgery, Global Open |
| title | Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy |
| title_full | Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy |
| title_fullStr | Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy |
| title_full_unstemmed | Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy |
| title_short | Real-world Medicare Healthcare Costs of Patients with Dupuytren’s Contracture Treated with Collagenase or Fasciectomy |
| title_sort | real world medicare healthcare costs of patients with dupuytren s contracture treated with collagenase or fasciectomy |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004480 |
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