Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Frequency of Gouty Arthritis Attacks and Presence of Comorbid Conditions Have An Impact on Gout-Related Healthcare Resource Utilization and Costs.
Saseen1, Joseph J., Agashivala2, Neetu, Allen3, Richard R., Ghushchyan1, Vahram, Nair1, Kavita V.
Gouty arthritis attacks cause significant pain and inflammation, and typically require medical intervention and pharmacotherapy for proper resolution. Although prior retrospective analyses have estimated health care costs associated with gouty arthritis attacks, predictors of patients with higher healthcare costs and the effect of comorbidities have not been completely assessed. We examined the impact of the cumulative number of attacks and comorbidities on healthcare expenditures.
We used the MarketScan database to identify patients > 18 years and above with an ICD9 code for gout (274.xx) or at least 1 prescription claim for specific gout-related medication (allopurinol, febuxostat, probenecid or colchicine) between July 1, 2005June 30, 2010. The date of the first diagnosis or prescription claim was the index date. Patients were required to have a minimum of 12 months pre and post enrollment data from the index date. Patients were categorized as having frequent gouty arthritis (>=3 attacks in the 1-year post index period) using a claims-based algorithm and were compared to patients with infrequent gouty arthritis (<3 attacks) who were matched in a 1:2 ratio on age, sex and geographic region. All costs were inflation adjusted to 2011 dollars.
A total of 5,222 patients with >=3 (frequent) and 10,444 patients <3 (infrequent) gouty arthritis attacks were identified. The mean age was 58 years and 77.3% were men. Patients with frequent gouty arthritis had a higher prevalence of comorbid conditions: chronic kidney disease, 12.2% vs. 7.2%; hypertension, 59.1% vs. 50.8%; heart failure, 10.1% vs. 6.8%; rheumatoid arthritis, 8.8% vs. 3.2% and osteoarthritis, 32.3% vs. 17.5% (all p<0.001). Mean number of all-cause and gout-related outpatient visits were 23.9 and 5.4 for patients with frequent gouty arthritis versus 17.3 and 1.2 for patients with infrequent gouty arthritis (between groups, both p<0.001). Mean gout-related medical costs and total costs expressed in 2011 dollars were $834 and $889 for patients with frequent gouty arthritis versus $176 and $210 for infrequent gouty arthritis (between groups, both p<0.001). Mean all-cause outpatient visits in patients with comorbid conditions compared with patients with only gouty arthritis were 25.8 vs. 11.8 in the frequent gouty arthritis group, and 19.8 vs. 8.5 in the infrequent gouty arthritis group (between groups, both p<0.001). Mean number of gout-related outpatient visits were higher in patients with comorbid conditions in the frequent gouty arthritis group (5.5 vs. 4.9, p<0.001), and in patient with infrequent gouty arthritis (1.2 vs. 1.1, p<0.001). However, mean gout related medical costs were higher in the frequent gouty arthritis group in patients with comorbid conditions ($886 vs. $513, p=0.03), but was similar in the infrequent gouty arthritis group in patients with comorbid conditions ($180 vs. $156, p=0.25).
Frequency of gouty arthritis attacks and presence of comorbid conditions are associated with higher health care costs. Severity of gouty arthritis and other health conditions should be considered when projecting health care costs in this population.
To cite this abstract, please use the following information:
Saseen, Joseph J., Agashivala, Neetu, Allen, Richard R., Ghushchyan, Vahram, Nair, Kavita V.; Frequency of Gouty Arthritis Attacks and Presence of Comorbid Conditions Have An Impact on Gout-Related Healthcare Resource Utilization and Costs. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :893