Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina
Background: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce. Objective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management inclu...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2023-10-01
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| Series: | Journal of Rehabilitation Medicine |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/jrm/article/view/11626 |
| _version_ | 1797645099215093760 |
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| author | Alberto Esquenazi Lisa Bloudek Kristen Migliaccio-Walle David Oliveri Amy Tung Patrick Gillard Monica Verduzco-Gutierrez |
| author_facet | Alberto Esquenazi Lisa Bloudek Kristen Migliaccio-Walle David Oliveri Amy Tung Patrick Gillard Monica Verduzco-Gutierrez |
| author_sort | Alberto Esquenazi |
| collection | DOAJ |
| description | Background: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce.
Objective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management including onabotulinumtoxinA.
Methods: This retrospective claims analysis of IBM MarketScan Commercial and Medicare Supplemental databases included adults with ≥ 1 onabotulinumtoxinA claim for post-stroke spasticity (1 January 2010 to 30 June 2018) and continuous enrolment for ≥ 12 months pre- and post-index (first onabotulinumtoxinA claim date). All-cause and spasticity-related healthcare resource utilization and costs were compared 12 months pre- and post-index (McNemar’s χ2 test or paired t-test). A subgroup analysis assessed effect of stroke-to-index interval on costs.
Results: Among 735 patients, mean (standard deviation) stroke-date-to-index-date interval was 284.5 (198.8) days. Decreases were observed post-index for mean all-cause outpatient (62.9 vs 60.5; p ≤ 0.05) and emergency department visits (1.1 vs 0.8; p ≤ 0.0001), and hospital admissions (1.5 vs 0.4; p ≤ 0.0001). Increase in prescription fills (43.0 vs 53.7) was seen post-index. Post-index decreases in all-cause (–66%) and spasticity-related (–51%) costs were driven by reduced inpatient care costs. Findings were consistent regardless of stroke-date-to-index-date interval.
Conclusion: Significant reductions in healthcare resource utilization and costs were observed after 1 year of post-stroke spasticity management including onabotulinumtoxinA. Long-term studies are needed to establish causality.
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| first_indexed | 2024-03-11T14:41:09Z |
| format | Article |
| id | doaj.art-7378e2f204a94305ba4738b297c34f25 |
| institution | Directory Open Access Journal |
| issn | 1651-2081 |
| language | English |
| last_indexed | 2024-03-11T14:41:09Z |
| publishDate | 2023-10-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj.art-7378e2f204a94305ba4738b297c34f252023-10-30T13:31:42ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812023-10-015510.2340/jrm.v55.11626Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxinaAlberto Esquenazi0Lisa Bloudek1Kristen Migliaccio-Walle2David Oliveri3Amy Tung4Patrick Gillard5Monica Verduzco-Gutierrez6MossRehab Gait and Motion Analysis Laboratory, Elkins Park, PA, USACurta, Inc., Seattle, WA, USACurta, Inc., Seattle, WA, USAGenesis Research, Hoboken, NJ, USAAllergan, an AbbVie Company, Chicago, IL, USAAllergan, an AbbVie Company, Chicago, IL, USALong School of Medicine at UT Health, San Antonio, TX, USABackground: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce. Objective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management including onabotulinumtoxinA. Methods: This retrospective claims analysis of IBM MarketScan Commercial and Medicare Supplemental databases included adults with ≥ 1 onabotulinumtoxinA claim for post-stroke spasticity (1 January 2010 to 30 June 2018) and continuous enrolment for ≥ 12 months pre- and post-index (first onabotulinumtoxinA claim date). All-cause and spasticity-related healthcare resource utilization and costs were compared 12 months pre- and post-index (McNemar’s χ2 test or paired t-test). A subgroup analysis assessed effect of stroke-to-index interval on costs. Results: Among 735 patients, mean (standard deviation) stroke-date-to-index-date interval was 284.5 (198.8) days. Decreases were observed post-index for mean all-cause outpatient (62.9 vs 60.5; p ≤ 0.05) and emergency department visits (1.1 vs 0.8; p ≤ 0.0001), and hospital admissions (1.5 vs 0.4; p ≤ 0.0001). Increase in prescription fills (43.0 vs 53.7) was seen post-index. Post-index decreases in all-cause (–66%) and spasticity-related (–51%) costs were driven by reduced inpatient care costs. Findings were consistent regardless of stroke-date-to-index-date interval. Conclusion: Significant reductions in healthcare resource utilization and costs were observed after 1 year of post-stroke spasticity management including onabotulinumtoxinA. Long-term studies are needed to establish causality. https://medicaljournalssweden.se/jrm/article/view/11626botulinum toxins, type Acost analysishealthcare resourcesmuscle spasticitystrokeutilization |
| spellingShingle | Alberto Esquenazi Lisa Bloudek Kristen Migliaccio-Walle David Oliveri Amy Tung Patrick Gillard Monica Verduzco-Gutierrez Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina Journal of Rehabilitation Medicine botulinum toxins, type A cost analysis healthcare resources muscle spasticity stroke utilization |
| title | Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina |
| title_full | Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina |
| title_fullStr | Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina |
| title_full_unstemmed | Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina |
| title_short | Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina |
| title_sort | healthcare resource utilization and costs among patients with post stroke spasticity before and after spasticity management including onabotulinumtoxina |
| topic | botulinum toxins, type A cost analysis healthcare resources muscle spasticity stroke utilization |
| url | https://medicaljournalssweden.se/jrm/article/view/11626 |
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