A Retrospective Study of Clinical and Economic Burden of Focal Segmental Glomerulosclerosis (FSGS) in the United States
Information on the economic burden of focal segmental glomerulosclerosis (FSGS) is sparse. This study characterized health care resource utilization (HCRU) and costs in patients with FSGS, and evaluated the impact of nephrotic range proteinuria on these outcomes. This retrospective, observational co...
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description | Information on the economic burden of focal segmental glomerulosclerosis (FSGS) is sparse. This study characterized health care resource utilization (HCRU) and costs in patients with FSGS, and evaluated the impact of nephrotic range proteinuria on these outcomes.
This retrospective, observational cohort study used administrative claims data from the Optum Clinformatics Data Mart Database from October 2015 to December 2019. Patients with FSGS (n = 844; first claim = index event) between April 2016 and December 2018 were matched on index date, age, sex, and race to non-FSGS controls (n = 1688). FSGS nephrotic range (urine protein/creatinine ratio >3000 mg/g or albumin/creatinine ratio >2000 mg/g) and non-nephrotic subpopulations were identified. Baseline comorbidities, 12-month post-index all-cause HCRU and costs (per patient per year [PPPY]), and immunosuppressant prescriptions were compared between matched cohorts and between FSGS subpopulations.
Comorbidity burden was higher in FSGS. Of 308 patients with available urine protein/creatinine ratio/albumin/creatinine ratio results, 36.4% were in nephrotic range. All-cause HCRU was higher in FSGS across resource categories (all P < 0.0001); 50.6% of FSGS and 23.3% of controls were prescribed glucocorticoids (P < 0.0001). Mean total medical costs were higher in FSGS ($59,753 vs. $8431 PPPY; P < 0.0001), driven by outpatient costs. Nephrotic range proteinuria was associated with higher all-cause inpatient, outpatient, and prescription costs versus nonnephrotic patients (all P < 0.0001), resulting in higher total costs ($70,481 vs. $36,099 PPPY; P < 0.0001).
FSGS is associated with significant clinical and economic burdens; the presence of nephrotic range proteinuria increased the economic burden. New treatment modalities are needed to reduce proteinuria, help improve patient outcomes, and reduce HCRU and associated costs.
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doi_str_mv | 10.1016/j.ekir.2021.07.030 |
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This retrospective, observational cohort study used administrative claims data from the Optum Clinformatics Data Mart Database from October 2015 to December 2019. Patients with FSGS (n = 844; first claim = index event) between April 2016 and December 2018 were matched on index date, age, sex, and race to non-FSGS controls (n = 1688). FSGS nephrotic range (urine protein/creatinine ratio >3000 mg/g or albumin/creatinine ratio >2000 mg/g) and non-nephrotic subpopulations were identified. Baseline comorbidities, 12-month post-index all-cause HCRU and costs (per patient per year [PPPY]), and immunosuppressant prescriptions were compared between matched cohorts and between FSGS subpopulations.
Comorbidity burden was higher in FSGS. Of 308 patients with available urine protein/creatinine ratio/albumin/creatinine ratio results, 36.4% were in nephrotic range. All-cause HCRU was higher in FSGS across resource categories (all P < 0.0001); 50.6% of FSGS and 23.3% of controls were prescribed glucocorticoids (P < 0.0001). Mean total medical costs were higher in FSGS ($59,753 vs. $8431 PPPY; P < 0.0001), driven by outpatient costs. Nephrotic range proteinuria was associated with higher all-cause inpatient, outpatient, and prescription costs versus nonnephrotic patients (all P < 0.0001), resulting in higher total costs ($70,481 vs. $36,099 PPPY; P < 0.0001).
FSGS is associated with significant clinical and economic burdens; the presence of nephrotic range proteinuria increased the economic burden. New treatment modalities are needed to reduce proteinuria, help improve patient outcomes, and reduce HCRU and associated costs.
[Display omitted]</description><identifier>ISSN: 2468-0249</identifier><identifier>EISSN: 2468-0249</identifier><identifier>DOI: 10.1016/j.ekir.2021.07.030</identifier><identifier>PMID: 34622107</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>claims analysis ; Clinical Research ; costs ; economic burden ; focal segmental glomerulosclerosis ; health care resource utilization ; nephrotic range proteinuria</subject><ispartof>Kidney international reports, 2021-10, Vol.6 (10), p.2679-2688</ispartof><rights>2021 International Society of Nephrology</rights><rights>2021 International Society of Nephrology. Published by Elsevier Inc.</rights><rights>2021 International Society of Nephrology. Published by Elsevier Inc. 2021 International Society of Nephrology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-80a4b89466a26c499625f21c1b4e5b923daf240b1ecdfe1138c5cf90afdda6bd3</citedby><cites>FETCH-LOGICAL-c455t-80a4b89466a26c499625f21c1b4e5b923daf240b1ecdfe1138c5cf90afdda6bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484118/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484118/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34622107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kalantar-Zadeh, Kamyar</creatorcontrib><creatorcontrib>Baker, Christine L.</creatorcontrib><creatorcontrib>Copley, J. Brian</creatorcontrib><creatorcontrib>Levy, Daniel I.</creatorcontrib><creatorcontrib>Berasi, Stephen</creatorcontrib><creatorcontrib>Tamimi, Nihad</creatorcontrib><creatorcontrib>Alvir, Jose</creatorcontrib><creatorcontrib>Udani, Suneel M.</creatorcontrib><title>A Retrospective Study of Clinical and Economic Burden of Focal Segmental Glomerulosclerosis (FSGS) in the United States</title><title>Kidney international reports</title><addtitle>Kidney Int Rep</addtitle><description>Information on the economic burden of focal segmental glomerulosclerosis (FSGS) is sparse. This study characterized health care resource utilization (HCRU) and costs in patients with FSGS, and evaluated the impact of nephrotic range proteinuria on these outcomes.
This retrospective, observational cohort study used administrative claims data from the Optum Clinformatics Data Mart Database from October 2015 to December 2019. Patients with FSGS (n = 844; first claim = index event) between April 2016 and December 2018 were matched on index date, age, sex, and race to non-FSGS controls (n = 1688). FSGS nephrotic range (urine protein/creatinine ratio >3000 mg/g or albumin/creatinine ratio >2000 mg/g) and non-nephrotic subpopulations were identified. Baseline comorbidities, 12-month post-index all-cause HCRU and costs (per patient per year [PPPY]), and immunosuppressant prescriptions were compared between matched cohorts and between FSGS subpopulations.
Comorbidity burden was higher in FSGS. Of 308 patients with available urine protein/creatinine ratio/albumin/creatinine ratio results, 36.4% were in nephrotic range. All-cause HCRU was higher in FSGS across resource categories (all P < 0.0001); 50.6% of FSGS and 23.3% of controls were prescribed glucocorticoids (P < 0.0001). Mean total medical costs were higher in FSGS ($59,753 vs. $8431 PPPY; P < 0.0001), driven by outpatient costs. Nephrotic range proteinuria was associated with higher all-cause inpatient, outpatient, and prescription costs versus nonnephrotic patients (all P < 0.0001), resulting in higher total costs ($70,481 vs. $36,099 PPPY; P < 0.0001).
FSGS is associated with significant clinical and economic burdens; the presence of nephrotic range proteinuria increased the economic burden. New treatment modalities are needed to reduce proteinuria, help improve patient outcomes, and reduce HCRU and associated costs.
[Display omitted]</description><subject>claims analysis</subject><subject>Clinical Research</subject><subject>costs</subject><subject>economic burden</subject><subject>focal segmental glomerulosclerosis</subject><subject>health care resource utilization</subject><subject>nephrotic range proteinuria</subject><issn>2468-0249</issn><issn>2468-0249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kUFr3DAQhU1paUKaP9BD0TE9rDOSZdmGUkiX7DYQCGSbs5ClcaKtLW0le0v-fWU2DcklJw28N29m9GXZZwo5BSrOtzn-tiFnwGgOVQ4FvMuOGRf1Ahhv3r-oj7LTGLcAQCtRNlB_zI4KLhijUB1nfy_ILY7Bxx3q0e6RbMbJPBLfkWVvndWqJ8oZcqm984PV5McUDLpZX_lZ3OD9gG5M1br3A4ap91H3mAJtJGerzXrzlVhHxgckd86OaNIANWL8lH3oVB_x9Ok9ye5Wl7-WPxfXN-ur5cX1QvOyHBc1KN7WDRdCMaF50whWdoxq2nIs24YVRnWMQ0tRmw4pLWpd6q4B1RmjRGuKk-z7IXc3tQManXYNqpe7YAcVHqVXVr5WnH2Q934va15zSusUcPYUEPyfCeMoBxs19r1y6KcoWVmDaCrgNFnZwarT-TFg9zyGgpyhya2cockZmoRKJmip6cvLBZ9b_iNKhm8HA6Zv2lsMMmqLTqOxITGTxtu38v8Bdb2qUA</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Kalantar-Zadeh, Kamyar</creator><creator>Baker, Christine L.</creator><creator>Copley, J. Brian</creator><creator>Levy, Daniel I.</creator><creator>Berasi, Stephen</creator><creator>Tamimi, Nihad</creator><creator>Alvir, Jose</creator><creator>Udani, Suneel M.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211001</creationdate><title>A Retrospective Study of Clinical and Economic Burden of Focal Segmental Glomerulosclerosis (FSGS) in the United States</title><author>Kalantar-Zadeh, Kamyar ; Baker, Christine L. ; Copley, J. Brian ; Levy, Daniel I. ; Berasi, Stephen ; Tamimi, Nihad ; Alvir, Jose ; Udani, Suneel M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-80a4b89466a26c499625f21c1b4e5b923daf240b1ecdfe1138c5cf90afdda6bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>claims analysis</topic><topic>Clinical Research</topic><topic>costs</topic><topic>economic burden</topic><topic>focal segmental glomerulosclerosis</topic><topic>health care resource utilization</topic><topic>nephrotic range proteinuria</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kalantar-Zadeh, Kamyar</creatorcontrib><creatorcontrib>Baker, Christine L.</creatorcontrib><creatorcontrib>Copley, J. Brian</creatorcontrib><creatorcontrib>Levy, Daniel I.</creatorcontrib><creatorcontrib>Berasi, Stephen</creatorcontrib><creatorcontrib>Tamimi, Nihad</creatorcontrib><creatorcontrib>Alvir, Jose</creatorcontrib><creatorcontrib>Udani, Suneel M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Kidney international reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kalantar-Zadeh, Kamyar</au><au>Baker, Christine L.</au><au>Copley, J. Brian</au><au>Levy, Daniel I.</au><au>Berasi, Stephen</au><au>Tamimi, Nihad</au><au>Alvir, Jose</au><au>Udani, Suneel M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Retrospective Study of Clinical and Economic Burden of Focal Segmental Glomerulosclerosis (FSGS) in the United States</atitle><jtitle>Kidney international reports</jtitle><addtitle>Kidney Int Rep</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>6</volume><issue>10</issue><spage>2679</spage><epage>2688</epage><pages>2679-2688</pages><issn>2468-0249</issn><eissn>2468-0249</eissn><abstract>Information on the economic burden of focal segmental glomerulosclerosis (FSGS) is sparse. This study characterized health care resource utilization (HCRU) and costs in patients with FSGS, and evaluated the impact of nephrotic range proteinuria on these outcomes.
This retrospective, observational cohort study used administrative claims data from the Optum Clinformatics Data Mart Database from October 2015 to December 2019. Patients with FSGS (n = 844; first claim = index event) between April 2016 and December 2018 were matched on index date, age, sex, and race to non-FSGS controls (n = 1688). FSGS nephrotic range (urine protein/creatinine ratio >3000 mg/g or albumin/creatinine ratio >2000 mg/g) and non-nephrotic subpopulations were identified. Baseline comorbidities, 12-month post-index all-cause HCRU and costs (per patient per year [PPPY]), and immunosuppressant prescriptions were compared between matched cohorts and between FSGS subpopulations.
Comorbidity burden was higher in FSGS. Of 308 patients with available urine protein/creatinine ratio/albumin/creatinine ratio results, 36.4% were in nephrotic range. All-cause HCRU was higher in FSGS across resource categories (all P < 0.0001); 50.6% of FSGS and 23.3% of controls were prescribed glucocorticoids (P < 0.0001). Mean total medical costs were higher in FSGS ($59,753 vs. $8431 PPPY; P < 0.0001), driven by outpatient costs. Nephrotic range proteinuria was associated with higher all-cause inpatient, outpatient, and prescription costs versus nonnephrotic patients (all P < 0.0001), resulting in higher total costs ($70,481 vs. $36,099 PPPY; P < 0.0001).
FSGS is associated with significant clinical and economic burdens; the presence of nephrotic range proteinuria increased the economic burden. New treatment modalities are needed to reduce proteinuria, help improve patient outcomes, and reduce HCRU and associated costs.
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subjects | claims analysis Clinical Research costs economic burden focal segmental glomerulosclerosis health care resource utilization nephrotic range proteinuria |
title | A Retrospective Study of Clinical and Economic Burden of Focal Segmental Glomerulosclerosis (FSGS) in the United States |
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