Abstract Number: PB1170
Meeting: ISTH 2020 Congress
Theme: Hemophilia and Rare Bleeding Disorders » Rare Bleeding Disorders
Background: Vaso-occlusive crises (VOCs) are common complications of sickle cell disease (SCD). Limited information exists in the literature on the economic burden of VOC management, especially as it pertains to inpatient VOC management.
Aims: To estimate US healthcare resource utilization associated with VOC management.
Methods: Retrospective database analysis was conducted using the IBM Watson Health MarketScan® Commercial Claims and Encounters database utilizing data over a 5-year period (Q3 2013-Q2 2018). Patients included had ≥2 diagnoses of SCD on different dates and ≥1 VOC diagnosis at age ≥6 years (both defined by ICD-9 or ICD-10 codes). Descriptive statistics were conducted for VOC-level demographic (age, sex) and clinical (Charlson comorbidity index [CCI] and VOC-related comorbidities) characteristics and main study outcomes (duration of inpatient VOCs and VOC-related healthcare costs by clinical setting adjusted to 2018 US dollars).
Results: A total of 69,662 VOCs, contributed by 8,045 SCD patients, were analyzed. Mean age ± standard deviation (SD) at VOC was 31.3 (±14.2) years, 78.4% of VOCs occurred in patients aged ≥14-50 years, and 58.9% of VOCs occurred in females. A majority of the VOCs (77.7%) were managed in the outpatient setting. Mean (±SD) CCI was 0.2 (±0.7), with chronic pulmonary disease, renal disease, and diabetes the most common comorbidities. Overall, mean (±SD) inpatient VOC duration was 6.7 (±6.0) days with most inpatient VOCs (60.4%) having a duration of ≥5 days. Mean healthcare cost (±SD) per VOC was $1,661 (±$11,164) and $22,044 (±$45,115) for outpatient and inpatient settings, respectively.
Conclusions: Over 20% of VOCs were managed in the inpatient setting, at a considerably higher mean cost (≈13x) than the cost of outpatient VOCs. Treatments for VOCs that reduce the duration of VOC-related inpatient stays or shift management to the outpatient setting would be expected to reduce the cost burden associated with VOC management.
To cite this abstract in AMA style:
Oladapo A, Swallow E, Briggs A, Zichlin ML, Mellgård B. Economic Burden Associated with Vaso-Occlusive Crisis Management in Patients with Sickle Cell Disease [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/economic-burden-associated-with-vaso-occlusive-crisis-management-in-patients-with-sickle-cell-disease/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/economic-burden-associated-with-vaso-occlusive-crisis-management-in-patients-with-sickle-cell-disease/