Wu and colleagues studied data for patients under age 65 with at least one diagnosis of Interstitial Cystitis (IC) from a de-identified administrative database of 2 million beneficiaries that included medical, drug and disability claims for 1999-2002. A matched control sample without a diagnosis of IC was used as a comparison.
The average IC patient had 130% higher direct costs and the average IC employee patient had 84% higher indirect costs than the average non-IC control. Relative risk was higher in the IC group for prostatitis, chronic pelvic pain, and endometriosis, vulvodynia, and urinary tract infections. Depression and anxiety was also more common in the IC group.
From a private third-party payer’s perspective, IC imposes a cost burden of $2309 in the first year after diagnosis, while from an employer’s perspective; the authors estimate the indirect cost at $726 per IC patient employee in the first year. From the private third party payer’s perspective, the average IC patient’s costs $3756 in excess direct costs and, from the employer’s perspective, an IC employee patient incurs excess costs of $3320 in both direct and indirect costs in the first year.
A relatively small percentage (17%) of IC patients in this study sample was treated with pentosanpolysulphate in the first year, and 47% did not receive any drug therapy. These figures probably reflect both the lack of efficacy of treatment for this condition as well as the lack of knowledge of treatment options among health care providers.
This is an interesting paper with the common limitations associated with claims data analyses in the absence of detailed clinical information. The field of pharmacoeconomics is a complex one, and while not an easy read, the paper is worth a look for those interested in the material.
By Philip Hanno, MD
Pharmacoeconomics 2006:24 (January) 55-65.
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