SESSION TITLE: COPD Posters III
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Disease management (DM) specifically tailored to patients with alpha-1 antitrypsin deficiency (AATD) has been shown to improve health-related quality of life and reduce healthcare utilization (Campos; 2009). Prolastin Direct® (PD) is a comprehensive program that provides coordinated augmentation therapy services (reimbursement, pharmacy, infusion) in conjunction with AATD-specific DM to patients treated with Prolastin/Prolastin-C. In order to better understand the impact of the PD program, healthcare utilization and costs were compared between patients in the PD program and patients receiving augmentation therapy with other alpha-1-proteinase inhibitors (A1PI).
METHODS: Patients with an ICD-9-CM COPD diagnosis (491.xx, 492.x, 496) treated with an A1PI (CPT J0256, J0257, S9346 or product-specific NDCs) between 2008 and 2014 were selected from the Optum Research and Impact National Benchmark Databases. The PD cohort comprised patients treated with Prolastin/Prolastin-C identified by product-specific NDCs and supplier codes; patients treated with other A1PIs were assigned to the comparator cohort; those with indeterminate A1PI brand were excluded. Healthcare utilization and costs (adjusted to 2013$) were compared between cohorts.
RESULTS: A total of 445 patients met inclusion criteria (213 PD and 232 comparator). There were no baseline demographic differences by group. Patients were 51% male with mean age of 55.5±10.1 years. Average length of follow up was 27±22 (range 1-75) months with mean monthly augmentation therapy costs of $9,901±6,015. Mean total monthly costs were $11,705±5,157 in the PD cohort vs $13,803±11,017 in the comparator cohort (p=0.010). Costs were skewed, with 2% of patients accounting for 10% of costs. Using a covariate-adjusted GLM (gamma distribution and log link) to account for skewness, cost differences remained statistically significant (p=0.020). Most of the lower costs in the PD group were attributed to reduced inpatient visits (number and length of stay), home health visits, and infusion costs.
CONCLUSIONS: Patients enrolled in the Prolastin Direct® program had lower average monthly healthcare utilization and costs versus patients receiving other augmentation therapy services.
CLINICAL IMPLICATIONS: This analysis suggests that the Prolastin Direct® program may result in reduced healthcare utilization and lower healthcare costs for AATD patients treated with an A1PI.
DISCLOSURE: Michael Campos: Grant monies (from industry related sources): Grifols, Grant monies (from industry related sources): CSL Behring Michael Runken: Employee: Grifols Angela Davis: Employee: Grifols Michael Johnson: Employee: employee of Optum which was contracted by Grifols to conduct this research Ami Buikema: Employee: I am an employee of Optum which was contracted by Grifols to conduct this research
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