Diffuse Lung Disease: Evaluation and Treatment of ILD |

Patterns of Care for Privately Insured Patients With Sarcoidosis FREE TO VIEW

Ennis James; Richard Rissmiller; Derek Low; Kit Simpson
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Medical University of South Carolina, Charleston, SC

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):482A. doi:10.1016/j.chest.2016.08.496
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SESSION TITLE: Evaluation and Treatment of ILD

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: The objectives of this study were to describe patterns of medication use and hospital admissions for patients with sarcoidosis identified in a large commercially insured US population.

METHODS: Data were extracted from the MarketScan® database covering privately insured adults age 18-64 during 2012. Individuals with at least two outpatient records with an ICD-9 diagnosis code of sarcoidosis were selected. All prescription medication, outpatient services and hospital admission records were extracted in addition to demographic variables. Summary measures of filled prescriptions and hospital use were constructed. Use of prednisone, methotrexate, azathioprine, infliximab, adalimumab, golimumab, and hydroxychloroquine were examined, as well number of hospital admissions and total days in the hospital observed during 2012.

RESULTS: Within the 2012 MarketScan® database, a total of 11,042 individuals with sarcoidosis were identified. Every US state was represented in the data with higher numbers of observations from the South Eastern states. A majority were female (59%), mean age was 49.3 years (SD 9.8). Of these, 1,792 (16.2%) had one or more hospital admissions (mean1.6 SD 1.3) during 2012 resulting in a mean of 8.1 hospital days (SD 14.5) used during the year for those patients with admissions. Prednisone was the most commonly prescribed medication with 25.5% use. Use of methotrexate was 2.7%, with 210 (1.9%) of patients on both prednisone and methotrexate. Use of hydroxychloroquine was 4.0%, azathioprine 1.2%, and biologics 0.6%. Prednisone doses ranged from 1-50mg per day, with a mean of 15mg/day (SD 8.1). The majority of patients (47%) received 20mg, and 36% received 10mg per day. Duration of prednisone use varied, with 39% filling prescriptions for less than 30 days, 42% receiving prednisone for 1 to 6 months and 19% having more than 6 months of use.

CONCLUSIONS: Sarcoidosis patients with private insurance have significant hospitalization rates and length of stay. Prednisone was the most common medication used for treatment of sarcoidosis, and less than 5% of patients received second-line medications.

CLINICAL IMPLICATIONS: Privately insured sarcoidosis patients have higher hospitalization rates and longer length of stay compared to the general population. Prednisone and second-line therapy use occur at a much lower rate than that reported by referral centers.

DISCLOSURE: The following authors have nothing to disclose: Ennis James, Richard Rissmiller, Derek Low, Kit Simpson

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