Healthcare utilization and costs in patients with tuberous sclerosiscomplex-related renal angiomyolipoma

Abstract

Objective: To quantify healthcare utilization and costs in patients with tuberous sclerosis complex (TSC) and renal angiomyolipoma (AML) in a matched cohort of patients without TSC or AML.

Methods: Administrative data from the MarketScan Research Databases were used to select patients with TSC and renal AML during January 1, 2000–March 31, 2013 from the Commercial database and January 1, 2000–June 30, 2012 from the Medicaid database. Patients were required to have at least 30 days of follow-up from initiation into the study, and were followed until inpatient death, end of insurance coverage, or the end of study. Age, calendar year, and payer-matched controls that had no TSC and no AML were selected. All-cause annualized healthcare utilization and costs were calculated by service category.

Results: A total of 218 patients under 18 years and 377 patients 18 years and older with TSC-renal AML were selected from the Commercial database, and matched to 654 and 1,131 controls, respectively. Thirty-eight patients under 18 years and 110 patients 18 years or older with TSC-renal AML were selected from the Medicaid database, and matched to 54 and 212 controls, respectively. Within the Commercial cohort, and across both age groups, TSC-renal AML patients utilized more healthcare services than their matched controls. Within the Medicaid cohort, in both age groups, utilization was higher in TSC-renal AML patients vs control patients for inpatient admissions, emergency room visits, physician office visits, and hospital-based outpatient visits. Across age groups and in both the Commercial and Medicaid cohorts, the annual average total costs were significantly higher in TSC-renal AML patients compared to control patients (p < 0.05 for all). Healthcare costs ranged from $29,240–$48,499 for TSC-renal AML patients and from $2,082–$10,864 for control patients.

Conclusions: Compared to controls, TSC-renal AML patients incurred substantially higher annual healthcare utilization and costs.

Keywords:

• Angiomyolipoma
• Healthcare utilization and costs
• Observational study
• Tuberous sclerosis

Transparency

Declaration of funding

The study was funded by Novartis Pharmaceutical Corporation.

Declaration of financial/other relationship

ZL, QS, and JP are employees of Novartis. HC, JH, and JB are paid consultants to Novartis. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to thank Michelle Shaw for providing medical writing assistance.