INTRODUCTION: We aim to quantify the impact of eosinophilic granulomatosis with polyangiitis (EGPA) on healthcare resource utilization (HCRU) and associated health insurer payment costs in a retrospective analysis of US administrative health insurance claims data (Merative™ MarketScan® databases).
METHODS: Patients with EGPA newly diagnosed during 2017–2021 with ≥12 months of continuous pre-diagnostic health plan enrollment and ≥1 inpatient or ≥2 outpatient EGPA-related diagnoses (≥90 days apart, ICD-10-CM code M30.1). Patients with EGPA were matched on demographic and enrollment characteristics with up to four people without EGPA from the general population. Follow-up ran from first observed EGPA diagnosis (index date) until health plan disenrollment or database end. Annualized HCRU and associated health insurer payment costs (not including deductible, co-pay or co-insurance) were assessed overall and by care setting.
RESULTS: Of 236 patients with incident EGPA, 213 were matched to 779 general insured patients. In matched patients with EGPA, mean (standard deviation) age at diagnosis was 49.6 (14.3) years, 59% were female and 90% had commercial insurance. Annualized all-cause HCRU was higher in patients with EGPA versus the matched general population for clinical encounters (≥1 inpatient visit: 44.6% vs 6.5%; ≥1 outpatient visit: 93.0% vs 53.8%; ≥1 emergency department visit: 31.5% vs 17.3%; ≥1 office visit: 97.2% vs 85.4%) and specialty claims (rheumatologist: 42.7% vs 2.4%; pulmonologist: 39.0% vs 2.8%; allergist/immunologist; 31.0% vs 2.1%). Annualized mean total all-cause insurer payment costs were 16-fold higher for patients with EGPA ($117,563) versus the matched general population ($7,520); the main cost drivers were inpatient ($46,410) and outpatient hospital visits ($26,544).
CONCLUSIONS: Patients with EGPA have a higher disease burden in terms of HCRU and associated payer costs than the demographically matched general population. More effective targeted treatments for EGPA are needed to induce and maintain remission and reduce clinical encounters.
