Study Evaluates Healthcare Utilization and Expenditures for Patients With NTM

Patients with nontuberculous mycobacterial lung disease (NTMLD) have a significant greater risk of hospitalization and higher total healthcare expenditures than matched control patients without NTMLD, according to new study results.

The study identified patients from a large US national managed care insurance database that consisted of aggregated health claims of up to 18 million fully covered members annually. The researchers required 36 months of continuous enrollment for the study and they summarized healthcare utilization and standardized healthcare expenditures over 12 months before NTMLD diagnosis and for 2 subsequent years.

“Despite increasing awareness of NTMLD, reports on the economic impact, including healthcare utilization and healthcare expenditures, are limited. In Germany, NTMLD was associated with a 3-fold increase in hospitalizations and a large attributable health care cost,” explained the authors. “In the United States, antibiotic costs of over $5000 per patient were identified in 1 cohort and prescription drug costs of $617 million per year overall have been estimated at the national level.”

In total, 1039 patients were in the NTMLD cohort, while 2078 patients were in the control cohort. The results revealed that NTMLD patients had a 55.0% risk of hospitalization in year 1 and a 38.8% risk in year 2. In addition, the adjusted risk of hospitalization was observed to be significantly higher in the NTMLD group compared with the control group in year 1 and year 2.

As for the healthcare expenditures, the total NTMLD population-adjusted mean expenditures were $72,475 for year 1 and $28,405 for the matched control population—a total difference of $44,070. For year 2, the adjusted mean expenditures were $48,114 for the overall NTMLD patient group and $28,990 for the matched control group—a difference of $19,124.

“Our estimates of NTMLD-related utilization and expenditures may be underestimated to some extent given the difficulty in diagnosing NTMLD, which has been shown to be delayed from symptom onset by an average of 5.2 years,” noted the authors. “We think that it is likely that some of the baseline year utilization and expenditures include those associated with the diagnostic process related to misdiagnosis, which would effectively dampen the measured effect of NTMLD seen in years 1 and 2 when making comparisons to baseline.”

Overall the authors concluded that the findings demonstrate the patients with NTMLD have a significantly greater risk of hospitalization and greater total health care expenditures than those without the disease. The study suggested that these findings underscore the economic burden of NTMLD in the United States.

Reference

Marras TK, Mirsaeidi M, Chou E, et al. Health care utilization and expenditures following diagnosis of nontuberculous mycobacterial lung disease in the United States. J Manag Care Spec Pharm. 2018 Oct;24(10):964-974. doi: 10.18553/jmcp.2018.18122.