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Economic Burden Associated with Major Surgery in Patients with von Willebrand Disease: A United States Retrospective
Abiola Oladapo1, Yanyu Wu2, Mei Lu3
1Baxalta US Inc., a Takeda Company, Cambridge, MA, USA.
Insights
Patients with von Willebrand disease (VWD) incur higher healthcare costs and resource use during major surgeries compared to those without VWD. This study quantifies the significant economic burden associated with VWD in surgical patients.
Area of Science:
- Health Economics
- Hematology
- Surgical Outcomes
Background:
- Von Willebrand disease (VWD) is a bleeding disorder that can complicate surgical procedures.
- Understanding the economic impact of VWD in patients undergoing major surgery is crucial for healthcare resource allocation.
Purpose of the Study:
- To estimate the incremental economic burden of major surgeries in patients with von Willebrand disease (VWD).
Main Methods:
- Retrospective analysis of the IBM Health MarketScan database (2008-2018).
- Propensity score matching (1:1) of patients with VWD and without VWD undergoing major surgery.
- Comparison of healthcare resource utilization and costs over a 12-month period post-surgery.
Main Results:
- Matched cohorts included 2972 pairs of patients.
- Patients with VWD had significantly higher rates of inpatient admissions (OR=1.71) and emergency room visits (OR=1.41).
- Total healthcare costs were substantially higher for patients with VWD ($50,733.89) compared to those without VWD ($30,154.84).
Conclusions:
- Major surgeries in patients with VWD are associated with significantly increased healthcare resource utilization.
- The economic burden, measured by total healthcare costs, is considerably higher for surgical patients with VWD.
Purpose:
To estimate the incremental economic burden of major surgeries in patients with von Willebrand disease (VWD).
Patients And Methods:
This was a retrospective analysis of the IBM Health MarketScan® database (2008-2018). Patients with at least two healthcare visits for VWD in the database who had undergone at least one major surgery unrelated to VWD (identified via International Classification of Diseases, Ninth and Tenth Revisions procedure codes) were included. Patients without VWD with major surgeries were selected from a 1% random database sample. All patients had ≥12 months of continuous healthcare plan enrollment before and following their first major surgery. Patients with VWD were matched (1:1) with patients without VWD using propensity score matching. Regression models compared healthcare resource utilization and costs between the matched cohorts over a 12-month period after patients' index major surgery.
Results:
After propensity score matching, 2972 pairs were selected. Musculoskeletal and digestive surgeries were the two most common major surgeries (patients with VWD, 39.6% and 25.0%; without VWD, 37.1% and 23.4%, respectively). Patients with VWD were significantly more likely (p<0.0001) to have an inpatient admission (odds ratio = 1.71; 95% confidence interval [CI] 1.52-1.92) or emergency room visit (odds ratio = 1.41; 95% CI 1.25-1.59) than patients without VWD. The numbers of inpatient admissions (incidence rate ratio [IRR] = 1.47; 95% CI 1.35-1.60), emergency room visits (IRR = 1.44; 95% CI 1.31-1.59), and outpatient visits (IRR = 1.16; 95% CI 1.11-1.21) per patient were also significantly greater for patients with VWD than for those without VWD (p<0.0001). Patients with VWD incurred significantly higher (p<0.0001) total healthcare costs (medical and pharmacy) per patient than patients without VWD ($50,733.89 versus $30,154.84, respectively).
Conclusion:
Healthcare resource utilization and associated costs among patients undergoing major surgeries were significantly higher for those with VWD than for patients without VWD.
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