Healthcare Resource Utilization and Costs Among Patients with Post-stroke Spasticity Before and After Spasticity Management Including Onabotulinumtoxina

Overview

Journal J Rehabil Med

Specialty Rehabilitation Medicine

Date 2023 Oct 30

PMID 37902443

Authors

Alberto Esquenazi

Lisa Bloudek

Kristen Migliaccio-Walle

David Oliveri

Amy Tung

Patrick Gillard

Monica Verduzco-Gutierrez

Affiliations

Soon will be listed here.

Abstract

Background: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce.

Objective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management including onabotulinumtoxinA.

Methods: This retrospective claims analysis of IBM MarketScan Commercial and Medicare Supplemental databases included adults with ≥ 1 onabotulinumtoxinA claim for post-stroke spasticity (1 January 2010 to 30 June 2018) and continuous enrolment for ≥ 12 months pre- and post-index (first onabotulinumtoxinA claim date). All-cause and spasticity-related healthcare resource utilization and costs were compared 12 months pre- and post-index (McNemar's χ2 test or paired t-test). A subgroup analysis assessed effect of stroke-to-index interval on costs.

Results: Among 735 patients, mean (standard deviation) stroke-date-to-index-date interval was 284.5 (198.8) days. Decreases were observed post-index for mean all-cause outpatient (62.9 vs 60.5; p ≤ 0.05) and emergency department visits (1.1 vs 0.8; p ≤ 0.0001), and hospital admissions (1.5 vs 0.4; p ≤ 0.0001). Increase in prescription fills (43.0 vs 53.7) was seen post-index. Post-index decreases in all-cause (-66%) and spasticity-related (-51%) costs were driven by reduced inpatient care costs. Findings were consistent regardless of stroke-date-to-index-date interval.

Conclusion: Significant reductions in healthcare resource utilization and costs were observed after 1 year of post-stroke spasticity management including onabotulinumtoxinA. Long-term studies are needed to establish causality.

Citing Articles

Efficacy of botulinum toxin A combined with extracorporeal shockwave therapy in post-stroke spasticity: a systematic review.

Du Y, Li Y, Zhang T, Jiang N, Wei Y, Cheng S Front Neurol. 2024; 15:1342545.

PMID: 38560731 PMC: 10979702. DOI: 10.3389/fneur.2024.1342545.

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