Respiratory and Pulmonary Medicine

Biography

Biography: Michael Philbin

Abstract

The objective of this study was to provide a contemporary estimate of the healthcare resource use (HCRU) and costs borne by commercial payers for sarcoidosis patients in the US. Patients (aged 18-64 years) with a first diagnosis of sarcoidosis between 1/1/1998 and 3/31/2015 were selected from a large, de-identified, privately-insured administrative claims database (OptumHealth Reporting and Insights). Costs (inpatient, outpatient/physician office, emergency department/other, pharmacy) were assessed from the payer perspective over 12 months post-diagnosis. To assess incremental HCRU and costs, sarcoidosis patients were matched (1:1) to non-sarcoidosis controls based on Charlson Comorbidity Index and propensity-score calculated by logistic regression with covariates for demographic characteristics and baseline HCRU and costs. A total of 7,119 sarcoidosis patients who met the sample selection criteria were matched with a control. Overall, commercial payers incurred $19,714 in total annual healthcare costs per sarcoidosis patient. The principle drivers of costs were outpatient visits ($9,050, 46%) and inpatient admissions ($6,398, 32%). Relative to controls, sarcoidosis patients had, on average, $5,190 (36%) higher overall total healthcare costs ($19,714 vs. $14,524; p<0.001). Using US  population and prevalence statistics from published literature, these results suggest that sarcoidosis patients impose a total direct medical cost burden of approximately $1.3 to $8.7 billion (in 2015$) to commercial payers – comparable to estimates of other autoimmune diseases such as rheumatoid arthritis, psoriaisis, or ulcerative colitis. These estimates, moreover, likely understate the actual burden because they excluded out-of-pocket costs, supplemental insurer payments, costs associated with premature mortality, reduced quality of life, and/or informal caregiving.