Clinical comorbidities, treatment patterns, and direct medical costs of patients with osteoarthritis in usual care

A retrospective claims database analysis

Mugdha Gore, Kei Sing Tai, Alesia Sadosky, Douglas Leslie, Brett R. Stacey

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Objective: Comorbidities and resource utilization among patients with osteoarthritis (OA) in clinical practice have been infrequently characterized. The purpose of this study was to examine comorbidities, pain-related pharmacotherapy, and direct medical costs of patients with OA in clinical practice. Method: This retrospective cohort analysis used medical and pharmacy claims data from the LifeLink™ Database. OA patients (ICD-9-CM codes 715.XX) were matched (age, gender, and region) with individuals without OA. Comorbidities, pain-related pharmacotherapy, and direct medical costs (pharmacy, outpatient, inpatient, total) were examined for the calendar year 2008. Results: The sample consisted of 112,951 OA patients and 112,951 controls (mean age: 56.9 [SD = 9.5] years; 62% female). Relative to controls, OA patients were significantly more likely (p <0.0001) to have comorbidities, including musculoskeletal (84.3 vs. 37.1%) and neuropathic pain (22.0 vs. 6.1%) conditions, depression (12.4 vs. 6.4%), anxiety (6.6 vs. 3.5%), and sleep disorders (11.9 vs. 4.2%). OA patients were significantly more likely (p <0.0001) to receive pain-related medications, including opioids (40.7 vs. 17.1%), NSAIDs (37.1 vs. 11.5%), tramadol (9.8 vs. 1.8%), and adjunctive medications for treating depression, anxiety, and insomnia. Mean [SD] total direct medical costs were more than two times higher among OA patients ($12,905 [$21,884] vs. $5099 [$13,855]; p <0.001) and median costs were more than three times higher ($6188 vs. $1879; p <0.0001). Study limitations include potential errors in coding and recording; overestimation of the comorbidity burden; inability to link condition of interest, OA, with prescribed medications; and possible underestimation of the true costs of OA, because indirect costs were not considered and the direct costs were from a third party payer (commercial insurance) perspective. Conclusion: The patient burden of OA was characterized by a high prevalence of comorbidities. The payer burden was also substantial, with significantly greater use of pain-related and adjunctive medications, and higher direct medical costs.

Original languageEnglish (US)
Pages (from-to)497-507
Number of pages11
JournalJournal of Medical Economics
Volume14
Issue number4
DOIs
StatePublished - Aug 2011

Fingerprint

Insurance Claim Review
Osteoarthritis
Comorbidity
Databases
Costs and Cost Analysis
Therapeutics
Pain
Anxiety
Depression
Health Insurance Reimbursement
Drug Therapy
Tramadol
Sleep Initiation and Maintenance Disorders
Neuralgia
International Classification of Diseases
Non-Steroidal Anti-Inflammatory Agents
Insurance
Opioid Analgesics
Inpatients
Cohort Studies

Keywords

  • Burden
  • Costs
  • Health resource utilization
  • Medications
  • Osteoarthritis

ASJC Scopus subject areas

  • Health Policy

Cite this

Clinical comorbidities, treatment patterns, and direct medical costs of patients with osteoarthritis in usual care : A retrospective claims database analysis. / Gore, Mugdha; Tai, Kei Sing; Sadosky, Alesia; Leslie, Douglas; Stacey, Brett R.

In: Journal of Medical Economics, Vol. 14, No. 4, 08.2011, p. 497-507.

Research output: Contribution to journalArticle

Gore, Mugdha ; Tai, Kei Sing ; Sadosky, Alesia ; Leslie, Douglas ; Stacey, Brett R. / Clinical comorbidities, treatment patterns, and direct medical costs of patients with osteoarthritis in usual care : A retrospective claims database analysis. In: Journal of Medical Economics. 2011 ; Vol. 14, No. 4. pp. 497-507.
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