1. Treatment patterns and healthcare resource utilization among patients with hereditary angioedema in the United States
- Author
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Riedl, Marc A, Banerji, Aleena, Manning, Michael E, Burrell, Earl, Joshi, Namita, Patel, Dipen, Machnig, Thomas, Tai, Ming-Hui, and Watson, Douglas J
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Health Services ,Angioedemas ,Hereditary ,Anti-Inflammatory Agents ,Non-Steroidal ,Bradykinin ,Bradykinin B2 Receptor Antagonists ,Complement C1 Inhibitor Protein ,Complement Inactivating Agents ,Humans ,Patient Acceptance of Health Care ,Peptides ,Retrospective Studies ,United States ,Central venous access device ,Claims data ,Healthcare resource utilization ,Hereditary angioedema ,Intravenous C1-inhibitor ,Real-world ,Treatment patterns ,Other Medical and Health Sciences ,Genetics & Heredity ,Genetics ,Clinical sciences - Abstract
BackgroundReal-world data on usage and associated outcomes with hereditary angioedema (HAE)-specific medications introduced to the United States (US) market since 2009 are very limited. The purpose of this retrospective study was to evaluate real-world treatment patterns of HAE-specific medications in the US and to assess their impact on healthcare resource utilization (HCRU). This analysis used IMS PharMetrics PlusTM database records (2006-2014) of patients with HAE, ≥1 insurance claim for an HAE-specific medication, and continuous insurance enrollment for ≥3 months following the first HAE prescription claim.ResultsOf 631 total patients, 434 (68.8%) reported C1-INH(IV) use; 396 (62.8%) reported using ecallantide and/or icatibant. There were 306 episodes of prophylactic use of C1-INH(IV) (defined by continuous refills averaging ≥1500 IU/week for ≥13 weeks) in 155 patients; use of ≥1 on-demand rescue medication was implicated during 53% (163/306) of those episodes. Sixty-eight (20.2%) of 336 C1-INH(IV) users eligible for the HCRU analysis were hospitalized at least once, and 191 (56.8%) visited the emergency department (ED). Eighteen patients (5.4%) had a central venous access device (CVAD); of these, 5 (27.7%) required hospitalization and 14 (77.7%) had an ED visit. The adjusted relative risk of hospitalization and/or ED visits for patients with a CVAD was 2.6 (95% CI: 0.17, 39.23) compared to C1-INH(IV) users without a CVAD.ConclusionsDespite widespread availability of modern HAE medications in the US, we identified a subset of patients requiring long-term prophylaxis who continue to be burdened by frequent rescue medication usage and/or complications related to the use of CVADs for intravenous HAE medication.
- Published
- 2018