P183 Burden of illness in school-aged patients with cystic fibrosis (CF) in the united states

Abstract

University School of Medicine and Rainbow Babies and Children's Hospital BACKGROUND: Cystic fibrosis (CF) is a rare, progressive genetic disease affecting patients from birth. The CF disease burden in schoolaged children is not well understood. OBJECTIVE: To describe the burden of CF in patients aged 6-17 years by comparing their healthcare resource utilization (HCRU) to that of demographically similar controls without CF. METHODS: This retrospective study used administrative claims from the Truven MarketScan Commercial (COMM) and Medicaid Multi- State (CAID) databases. Patients with CF aged 6-17 years were identified as having ≥ 1 inpatient (IP) or ≥ 2 outpatient (OP) medical claims ≥ 30 days apart with primary diagnosis of CF (ICD-9-CM: 277.0x) between 2010 and 2014. Other inclusion criteria were ≥ 12 months of continuous medical and pharmacy coverage and ≥ 1 healthcare encounter due to CF during the most recent year of data. Patients were matched (1:3) to non-CF controls by age, gender, geographic region (COMM cohort), race (CAID cohort), enrollment (calendar year) and insurance plan type. The most recent year of data was used to assess outcomes, which included IP admissions, OP visits and medication use. Bivariate statistics were used to compare outcomes between patients and matched controls, overall and by age group (6-11 and 12-17 years) using chi-square tests for categorical variables and t-tests and ANOVA for continuous variables. RESULTS: In total, 2,400 patients with CF were included in the COMM cohort and 1,264 in the CAID cohort; all were matched 1:3 to controls (n = 7,200 and n = 3,792, respectively); mean [SD] age of patients and controls: COMM, 11.9 [3.5]; CAID, 11.4 [3.5]. Annual hospitalization rates were ≥ 22-fold higher in the CF cohorts vs. matched controls (COMM, 0.64 vs. 0.02; CAID, 0.87 vs. 0.04) with longer lengths of stay per hospitalization (COMM, 8.4 vs. 4.5 days; CAID, 10.1 vs. 6.8). Higher annual rates of OP visits were evident in the CF cohorts vs. controls (COMM, 9.9 vs. 2.8; CAID, 9.9 vs. 3.2). Patients filled 5 times as many unique medications (COMM, 11.6 vs. 2.0; CAID, 15.8 vs. 3.2) and 10 times as many total prescriptions per year than controls (COMM, 39.8 vs. 3.6; CAID, 67.3 vs. 7.2). P values were < 0.001 for all comparisons (CF patients vs. controls). While patients aged 12-17 years generally had greater HCRU than those aged 6-11, trends and magnitude difference vs. controls within each age group were similar. CONCLUSIONS: Patients with CF aged 6-17 years have greater HCRU than demographically similar non-CF controls, illustrating significant disease burden and a need for better treatment options in this schoolage population.