The economic burden of CIDP in the United States: A case-control study

Abstract

Background Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare neurological disorder of the peripheral nervous system. The economic burden of CIDP is not well understood. Objectives To assess the economic and clinical burden of CIDP and to compare the incremental burden relative to a matched control group without CIDP. Methods This retrospective case-control analysis was conducted using data from the IQVIA Real- World Data Adjudicated Claims. Adults newly diagnosed with CIDP between 7/1/2010 and 6/30/2014 were identified and direct matched to controls without CIDP. Baseline characteristics were assessed and compared over a 6-month pre-index period. Healthcare resource use, costs and clinical characteristics were assessed and compared over a 2-year followup. Total cost differences over the 2-year follow-up were compared between matched cohorts using a generalized estimating equation model. Results The final sample comprised a total of 790 cases matched to 790 controls. Over the 2-year follow-up, cases more frequently experienced neuropathic pain, back pain and osteoarthritis and more commonly utilized opioids, anti-convulsants and anti-depressants. Compared to controls, more cases had ?1 hospitalization (26.2% vs. 9.0%), and cases had a higher mean number of outpatient prescription fills (62.8 vs. 32.0) and physician office visits (34.7 vs. 13.0) (all p<0.0001). Cases had 7.5x higher mean total costs ($116, 330 vs. $15, 586, p<0.0001). Important cost drivers were costs for outpatient ancillary, radiology and HCPCS drugs (mean $76, 366 vs. $4, 292) and costs for inpatient care (mean $16, 357 vs. $2, 862) (both p<0.0001). Among cases, CIDP therapy (inclusive of both outpatient pharmacy and medical claims) accounted for 51.2% of mean total costs. After further adjusting for baselineclinical characteristics, cases were associated with a 6.1x increase in total costs compared to controls (p<0.0001). Conclusions Our findings suggest a substantial clinical and economic burden among patients with CIDP relative to matched controls over a 2-year follow-up.