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Clinical and Economic Burden of Herpes Zoster in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study Using Administrative Claims

Authors :
David Singer
Philippe Thompson-Leduc
Sara Poston
Deepshekhar Gupta
Wendy Y. Cheng
Siyu Ma
Francesca Devine
Alexandra Enrique
Mei Sheng Duh
Jeffrey R. Curtis
Source :
Rheumatology and Therapy, Vol 10, Iss 4, Pp 933-950 (2023)
Publication Year :
2023
Publisher :
Adis, Springer Healthcare, 2023.

Abstract

Abstract Objective To estimate the incremental healthcare resource utilization (HRU) and cost burden posed by herpes zoster (HZ) in adult patients with rheumatoid arthritis (RA) in the United States. Methods A retrospective cohort study was conducted using an administrative claims database containing commercial and Medicare Advantage with Part D data, between October 2015 and February 2020. Patients with RA and HZ (RA+/HZ+) or RA without HZ (RA+/HZ−) were identified based on diagnosis codes and relevant medications. Outcomes measured included HRU and medical, pharmacy, and total costs at month 1, quarter 1, and year 1 after the index date (HZ diagnosis for RA+/HZ+ cohort, randomly assigned for RA+/HZ− cohort). Generalized linear models incorporating propensity scores and other covariates were used to estimate differences in outcomes between cohorts. Results A total of 1866 patients from the RA+/HZ+ cohort and 38,846 patients from the RA+/HZ− cohort were included. Hospitalizations and emergency department visits occurred more frequently in the RA+/HZ+ than the RA+/HZ− cohort, especially in the month after HZ diagnosis (adjusted incidence rate ratio [95% confidence interval (CI)] for hospitalizations: 3.4 [2.8; 4.2]; emergency department visits: 3.7 [3.0; 4.4]). Total costs were also higher in the month after HZ diagnosis (mean adjusted cost difference [95% CI]: $3404 [$2089; $4779]), with cost differences driven by increased medical costs ($2677 [$1692; $3670]). Conclusions These findings highlight the high economic burden of HZ among individuals with RA in the United States. Strategies to reduce the risk of HZ in patients with RA (such as vaccination) may serve to reduce this burden. Video abstract

Details

Language :
English
ISSN :
21986576 and 21986584
Volume :
10
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Rheumatology and Therapy
Publication Type :
Academic Journal
Accession number :
edsdoj.4072b9820b02417cae15739e5ac074a0
Document Type :
article
Full Text :
https://doi.org/10.1007/s40744-023-00549-x