| Title: |
Evaluation of treatment patterns, healthcare resource utilization and cost of illness for sickle cell disease in Ghana: a private medical insurance claims database study. |
| Authors: |
Marfo, Kwaku1 (AUTHOR), Dei-Adomakoh, Yvonne2,3 (AUTHOR), Segbefia, Catherine2,3 (AUTHOR), Dwomoh, Duah3 (AUTHOR), Edgal, Adeline4 (AUTHOR), Ampah, Nancy5 (AUTHOR), Ramachandrachar, Badarinath Chickballapur6 (AUTHOR) BCRamachandrachar@ae.imshealth.com, Subramanyam, Kumaresan7 (AUTHOR), Natarajan, Ashok6 (AUTHOR), Egbujo, Olufolake8 (AUTHOR), Ataga, Kenneth I.9 (AUTHOR) |
| Source: |
BMC Health Services Research. 9/21/2023, Vol. 23 Issue 1, p1-14. 14p. 1 Diagram, 6 Charts, 1 Graph. |
| Subject Terms: |
*SICKLE cell anemia, *ECONOMIC aspects of diseases, *HEALTH insurance, *DATABASES, *INSURANCE claims |
| Geographic Terms: |
GHANA, SUB-Saharan Africa |
| Abstract: |
Background: Sickle cell disease (SCD) is a major public health concern in sub-Saharan Africa, accounting for nearly 75% of the global disease burden. The current analysis evaluated patient characteristics, treatment patterns, healthcare resource utilization (HCRU) and associated costs in patients with SCD based on a Private Medical Insurance Database in Ghana. Methods: This retrospective longitudinal cohort study was conducted using an e-claims database from Ghana (01 January 2015 to 31 March 2021). Patients were stratified by age (0 month to < 2 years, ≥ 2 years to ˂6 years, ≥ 6 years to < 12 years, ≥ 12 years to < 16 years; ≥16 years), vaso-occlusive crisis (VOC) (< 1, ≥ 1 to < 3, and ≥ 3 per year), and continuous enrolment. Study outcomes related to patient characteristics, comorbidities, treatment pattern, HCRU were evaluated for pre- and post-index period (index period was between July 2015 to March 2020). Descriptive analysis was used to analyse different study variables. Results: The study included 2,863 patients (mean age: 20.1 years; Min age: 0; Max age: 83; females 56.1%). Overall, 52.2% (n = 1,495) of SCD patients were ≥ 16 years and 17.0% (n = 486) were in the ≥ 2 to ˂6-years age group. The majority of patients aged ≥ 16 years (62.5%) in the database did not have reported VOC episodes, 35.9% of patients had 1 to 3 VOCs per year and 1.5% had ≥ 3 VOCs per year during the follow-up period. Consultation-based prevalence of SCD was 0.5% [95% confidence interval (CI): 0-1.3%] − 1.4% [CI: 0.6-2.2%]. Malaria, upper respiratory tract infection (URTI) and sepsis were the common complications of SCD. Analgesics were the most frequently prescribed medications followed by anti-infectives, hematinics, and antimalarials. Hydroxyurea, a routine standard of care for SCD was under-utilized. SCD patients had median cost incurred for consultation/hospital services of $11.3 (Interquartile range [IQR] $6.2 - $27.2). For patients with VOC, maximum median cost was incurred for medications ($10.9 [IQR $5.0-$32.6]). Overall median healthcare cost was highest for individuals with ≥ 3 VOCs per year during the follow-up period ($166.8 [IQR $70.3-$223.5]). Conclusion: In this retrospective private insurance claims database analysis, SCD imposes a significant healthcare burden, especially in patients with VOC. There is a need for reimbursed treatment options that could reduce the long-term burden associated with SCD and VOC. [ABSTRACT FROM AUTHOR] |
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