Estimating the Cost of Illness of Giant Cell Arteritis in the United States

Overview

Journal Rheumatol Ther

Specialty Rehabilitation Medicine

Date 2017 Jan 14

PMID 28084585

Citations 9

Authors

Joseph B Babigumira

Meng Li

Denise M Boudreau

Jennie H Best

Louis P Garrison Jr

Affiliations

Soon will be listed here.

Abstract

Introduction: Giant cell arteritis (GCA) is a chronic vasculitis affecting approximately 230,000 Americans. Limited data exist on the healthcare resource utilization and costs attributable to GCA. The objective of this study was to estimate the cost of illness in patients with GCA in the US.

Methods: A cohort of patients with a new GCA diagnosis was identified from a large US claims database between 1 January 2008 and 31 December 2012. Newly diagnosed GCA patients were defined by two claims with GCA (ICD-9 446.5) as one of the listed diagnoses during the study period and no GCA diagnosis in the 12 months prior. Subjects without a GCA diagnosis were matched 5:1 to cases. One-year healthcare costs were compared among cases and controls, adjusting for covariates using generalized linear models.

Results: A cohort of 1293 GCA patients and 6465 controls was identified. The mean age was 73 years, and 69% were females. Mean Charlson Comorbidity Index was 1.9 for GCA patients and 1.0 for controls. Mean 1-year cost for GCA patients was $34,065 [standard deviation (SD) $52,411], and mean 1-year cost for controls was $12,890 (SD $37,345). After multivariate adjustment, the difference in 1-year cost between GCA patients and controls was $16,431 (95% CI $13,821-$19,041).

Conclusions: Patients with GCA experience substantially higher healthcare costs in the first year following diagnosis compared to patients without GCA. These results add to the limited evidence available to inform researchers, clinicians, and policymakers on the cost burden of GCA in the US.

Funding: Genentech Inc.

Citing Articles

Unveiling the Uncommon: A Case Report of Horner's Syndrome as a Rare Glimpse Into Giant Cell Arteritis.

Barr E, Levesque J, Badir J, Dunston R, Ranasinghe T Case Rep Neurol Med. 2024; 2024:2503963.

PMID: 39691739 PMC: 11651727. DOI: 10.1155/crnm/2503963.

Diagnostic delays in systemic vasculitides.

Auanassova A, Yessirkepov M, Zimba O, Ahmed S, Mruthyunjaya P Rheumatol Int. 2024; 44(6):1003-1011.

PMID: 38587659 DOI: 10.1007/s00296-024-05582-9.

Analysis of Emergency Department Visits by Patients With Giant Cell Arteritis: A National Population-Based Study.

Hino C, Edigin E, Aihie O, Eseaton P, Okpujie V, Onobraigho P Cureus. 2023; 15(2):e35121.

PMID: 36945258 PMC: 10024958. DOI: 10.7759/cureus.35121.

Burden, Causes, and Outcomes of Hospitalization in Patients With Giant Cell Arteritis: A US National Cohort Study.

Goulabchand R, Qian A, Nguyen N, Singh A, Roubille C, Parreau S Arthritis Care Res (Hoboken). 2022; 75(8):1830-1837.

PMID: 36576029 PMC: 10300231. DOI: 10.1002/acr.25081.

Arterial-embolic Strokes and Painless Vision Loss Due to Phase II Aortitis and Giant Cell Arteritis: A Case Report.

Endres K, Anjum O, Costain N Clin Pract Cases Emerg Med. 2021; 5(2):174-177.

PMID: 34436998 PMC: 8143833. DOI: 10.5811/cpcem.2021.2.51143.

References

Cotch M . The socioeconomic impact of vasculitis. Curr Opin Rheumatol. 2000; 12(1):20-3. DOI: 10.1097/00002281-200001000-00004. View

Gonzalez-Gay M, Pina T . Giant cell arteritis and polymyalgia rheumatica: an update. Curr Rheumatol Rep. 2015; 17(2):6. DOI: 10.1007/s11926-014-0480-1. View

van Staa T, Abenhaim L, Cooper C, Zhang B, Leufkens H . The use of a large pharmacoepidemiological database to study exposure to oral corticosteroids and risk of fractures: validation of study population and results. Pharmacoepidemiol Drug Saf. 2008; 9(5):359-66. DOI: 10.1002/1099-1557(200009/10)9:5<359::AID-PDS507>3.0.CO;2-E. View

Weyand C, Liao Y, Goronzy J . The immunopathology of giant cell arteritis: diagnostic and therapeutic implications. J Neuroophthalmol. 2012; 32(3):259-65. PMC: 4278656. DOI: 10.1097/WNO.0b013e318268aa9b. View

Sjolander A, Greenland S . Ignoring the matching variables in cohort studies - when is it valid and why?. Stat Med. 2013; 32(27):4696-708. DOI: 10.1002/sim.5879. View

Fuldeore M, Yang H, Du E, Soliman A, Wu E, Winkel C . Healthcare utilization and costs in women diagnosed with endometriosis before and after diagnosis: a longitudinal analysis of claims databases. Fertil Steril. 2014; 103(1):163-71. DOI: 10.1016/j.fertnstert.2014.10.011. View

Petri H, Nevitt A, Sarsour K, Napalkov P, Collinson N . Incidence of giant cell arteritis and characteristics of patients: data-driven analysis of comorbidities. Arthritis Care Res (Hoboken). 2014; 67(3):390-5. DOI: 10.1002/acr.22429. View

Joish V, Spilsbury-Cantalupo M, Operschall E, Luong B, Boklage S . Economic burden of non-cystic fibrosis bronchiectasis in the first year after diagnosis from a US health plan perspective. Appl Health Econ Health Policy. 2013; 11(3):299-304. DOI: 10.1007/s40258-013-0027-z. View

Lawrence R, Felson D, Helmick C, Arnold L, Choi H, Deyo R . Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008; 58(1):26-35. PMC: 3266664. DOI: 10.1002/art.23176. View

10.

Singh A, Kermani T, Crowson C, Weyand C, Matteson E, Warrington K . Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort. J Rheumatol. 2014; 42(2):309-15. PMC: 4367485. DOI: 10.3899/jrheum.140188. View

11.

Hoffman G, Cid M, Hellmann D, Guillevin L, Stone J, Schousboe J . A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis Rheum. 2002; 46(5):1309-18. DOI: 10.1002/art.10262. View

12.

Basu A, Rathouz P . Estimating marginal and incremental effects on health outcomes using flexible link and variance function models. Biostatistics. 2004; 6(1):93-109. DOI: 10.1093/biostatistics/kxh020. View

13.

Fu A, Jhaveri M . Healthcare cost attributable to recently-diagnosed breast cancer in a privately-insured population in the United States. J Med Econ. 2012; 15(4):688-94. DOI: 10.3111/13696998.2012.673524. View

14.

Diehr P, Yanez D, Ash A, HORNBROOK M, Lin D . Methods for analyzing health care utilization and costs. Annu Rev Public Health. 1999; 20:125-44. DOI: 10.1146/annurev.publhealth.20.1.125. View

15.

Blough D, Madden C, Hornbrook M . Modeling risk using generalized linear models. J Health Econ. 1999; 18(2):153-71. DOI: 10.1016/s0167-6296(98)00032-0. View

16.

Nuenninghoff D, Hunder G, Christianson T, McClelland R, Matteson E . Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years. Arthritis Rheum. 2003; 48(12):3522-31. DOI: 10.1002/art.11353. View

17.

van Staa T, Leufkens H, Cooper C . The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int. 2002; 13(10):777-87. DOI: 10.1007/s001980200108. View

18.

Bongartz T, Matteson E . Large-vessel involvement in giant cell arteritis. Curr Opin Rheumatol. 2005; 18(1):10-7. DOI: 10.1097/01.bor.0000197996.04709.4e. View

19.

Diamantopoulos A, Haugeberg G, Lindland A, Myklebust G . The fast-track ultrasound clinic for early diagnosis of giant cell arteritis significantly reduces permanent visual impairment: towards a more effective strategy to improve clinical outcome in giant cell arteritis?. Rheumatology (Oxford). 2015; 55(1):66-70. DOI: 10.1093/rheumatology/kev289. View

20.

Salvarani C, Cantini F, Boiardi L, Hunder G . Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med. 2002; 347(4):261-71. DOI: 10.1056/NEJMra011913. View