Healthcare resource utilization and economic impact of a ≥2 g/dL decrease in hemoglobin in osteoarthritis patients.

Area of Science:

• Gastroenterology
• Rheumatology
• Health Economics

Background:

• Chronic occult blood loss in non-steroidal anti-inflammatory drug (NSAID) users can lead to hemoglobin decrease.
• Hemoglobin reduction may result in elevated healthcare expenditures, particularly in osteoarthritis patients.

Purpose of the Study:

• To quantify healthcare resource utilization associated with a ≥2 g/dL hemoglobin decrease in osteoarthritis patients using NSAIDs.
• To compare healthcare resource utilization between NSAID users with significant hemoglobin drop and those without.

Main Methods:

• Retrospective analysis of a large US managed care database.
• Inclusion criteria: osteoarthritis patients (≥18 years) with ≥90 days of NSAID use, and hemoglobin values before and after NSAID exposure.
• Comparison groups: patients with ≥2 g/dL hemoglobin drop versus controls with ≤0.5 g/dL hemoglobin drop.

Main Results:

• Patients with a ≥2 g/dL hemoglobin drop (n=228) showed higher rates of endoscopic procedures (e.g., colonoscopy) compared to controls (n=1572).
• The hemoglobin drop group had significantly higher healthcare resource utilization, including hospitalizations, outpatient visits, and physician visits.
• Total adjusted healthcare charges were substantially higher in the hemoglobin drop group ($47,766) compared to the control group ($23,342) over 12 months.

Conclusions:

• NSAID users with significant hemoglobin drops experienced greater subsequent healthcare utilization and incurred higher charges.
• While the source of blood loss was assumed to be gastrointestinal, it was not verified.
• The study highlights the economic burden associated with NSAID-induced hemoglobin decrease in osteoarthritis patients.