Healthcare Resource Utilisation and Costs in Patients with Eosinophilic Granulomatosis with Polyangiitis: A Retrospective Analysis of German Insurance Claims Data.
Paul Dolin, Anat Shavit, Jennifer Rowell, Chris Edmonds, Josefine Persson, Danuta Kielar, Keltie McDonald, Antje Mevius, Bernhard Hellmich, Stephanie Y Chen
Abstract
Open AccessINTRODUCTION: Evidence is limited on the clinical and economic burden of eosinophilic granulomatosis with polyangiitis (EGPA) in Europe. We evaluated EGPA healthcare resource utilisation (HCRU), days off work, and costs in Germany. METHODS: This analysis used claims data from the German statutory health insurance fund AOK Plus. Patients with newly diagnosed EGPA (index date 2016-2020; ≥ 12 months pre-diagnosis health plan enrolment) were matched (1:4) with general insured individuals without EGPA. Baseline was 12 months pre-diagnosis; follow-up was until 31 December 2020, insurance disenrollment, or death. Outcomes included HCRU and related costs and days off work. RESULTS: The study included 155 patients and 620 matched individuals. In the EGPA cohort, all-cause HCRU was higher post-diagnosis than during baseline in all categories. Mean annualised in-patient hospitalisations/patient and pharmacy claims/patient for any EGPA therapy were 2.99 and 5.87, respectively, during 1-year post-diagnosis versus 1.15 and 1.80, respectively, during baseline. Mean total annualised cost of all-cause HCRU/patient with EGPA was €19,700 during 1-year post-diagnosis versus €6,678 during baseline, with in-patient hospitalisations and pharmacy costs the main cost drivers of EGPA care. Over 5 years post-diagnosis, mean annualised HCRU rate per patient was significantly higher for the EGPA versus the matched cohort for all evaluated aspects of HCRU (p < 0.001). The mean total annualised all-cause HCRU cost was sevenfold higher (EGPA €14,771/patient vs matched cohort €2,094/patient; p < 0.001). In-patient hospitalisation (€8,276/patient) was the single largest driver of all-cause costs over 5 years post-diagnosis. Mean total days off work and associated annualised costs of productivity loss were also significantly higher over 5 years post-diagnosis in the EGPA versus the matched cohort (30.74 vs 13.35 days/year; €3,632 vs €1,555 annually/patient, both p < 0.001). CONCLUSIONS: These real-world data highlight the substantial economic burden associated with EGPA, characterised by increased HCRU, costs and productivity losses, underscoring the need for effective management strategies.