Prevalence of primary immune thrombocytopenia and related healthcare resource utilization among Texas Medicaid beneficiaries

Abstract

Objective

To estimate the prevalence of primary immune thrombocytopenia (ITP) and describe ITP-associated healthcare resource utilization (HRU) among Texas Medicaid beneficiaries.

Methods

A retrospective analysis using 2012–2015 Texas Medicaid claims data was conducted to estimate the annual prevalence of ITP. HRU was summarized for the 12-month period following initial ITP diagnosis. Logistic regression and generalized linear model were used to investigate predictors for all-cause and ITP-related HRU.

Results

The average annual prevalence of ITP was 17.0 per 100,000 persons; higher among females vs males (17.4 vs 13.6 per 100,000) and highest among adults aged ≥ 65 years (36.7 per 100,000). Among 325 patients included in the HRU analyses, 49.2% received ITP therapies. More than half of patients had at least one all-cause emergency department (ED) visit (70.5%) and/or hospitalization (56.0%). One-third (32.6%) experienced at least one ITP-related ED visit and 40.3% had at least one ITP-related hospitalization. Compared to adults aged 18–49 with ITP, children aged 0–4 (odds ratio [OR] = 3.65, p = .0008) and aged 5–17 (OR = 2.68, p = .0074) were more likely to have an ITP-related hospitalization; children aged 0–4 (OR = 4.36, p = .0005) and children aged 5–17 (OR = 4.09, p = .0005) were more likely to have an ITP-related ED visit during the follow-up period.

Conclusion

There are 17 patients diagnosed with ITP for every 100,000 Texas Medicaid enrollees annually, with higher prevalence in females and the elderly. Children are more likely to experience hospitalizations and ED visits associated with ITP. ITP patients in Texas Medicaid utilize more healthcare resources compared to the general Medicaid population.

Keywords:

• Immune thrombocytopenia
• healthcare resource utilization
• retrospective claims
• analysis
• Medicaid

Transparency

Declaration of funding

The study did not receive any external funding.

Declaration of financial/other relationships

Yi Liang worked as a summer intern for Novartis from June 2019 to August 2019; Karen Rascati received grants from Pfizer, Amgen, AbbVie and UBC in the last 2 years; Kristin Richards received grants from Cerevel, Novartis, and Pfizer in the last 2 years. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Study design and concept: Yi Liang, Karen Rascati; Data analyses: Yi Liang, Karen Rascati, Kristin Richards; Interpretation of data and critical revision of the manuscript: Yi Liang, Karen Rascati, Kristin Richards; All authors have read and approved the final draft of the manuscript submitted.

Acknowledgements

We thank the Texas Health and Human Services Commission for providing data for this project.

Previous presentations

Part of the results were presented in abstracts or posters in the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) annual conferences 2019 & 2020 and the Academy of Managed Care Pharmacy (AMCP) annual conference 2020.