Real-world healthcare costs and resource utilization in patients with von Willebrand disease and angiodysplasia

ABSTRACT

Objective

To describe the economic burden among VWD patients with angiodysplasia compared to VWD patients without angiodysplasia and the general population.

Methods

This was a retrospective analysis using the Merative MarketScan Commercial and Medicare Databases® (January 2011-September 2020). Selected patients had ≥1 medical claim for VWD or low VWF, ≥1 medical claim for AGD, and ≥3 GI-related bleeding episodes within a year. HCRU and all-cause costs were compared with the VWD (only) and the general cohorts.

Results

The mean total all-cause costs were $150,101 among patients with VWD and angiodysplasia (n = 34), higher compared to $48,249 among matched VWD patients without angiodysplasia (n = 136) and $31,029 among matched individuals of the general population [n = 136; p-value < 0.0001]. The differences in costs between groups were primarily due to inpatient care. During the 12-month follow-up, VWD patients with symptomatic (n = 35), asymptomatic (n = 81), and suspected (n = 378) angiodysplasia had an average of 4.1, 0.6, and 3.8 gastrointestinal (GI) bleeds, respectively. Desmopressin, VWF concentrates, and aminocaproic acid were the most frequent treatments used. The most frequent procedures to treat GI-related bleeding and underlying lesions were blood transfusion and laser therapy.

Conclusions

Despite recent therapeutic advances, there is room for considerable reduction of the disease burden in patients with VWD and angiodysplasia.

KEYWORDS:

• Von Willebrand disease (VWD)
• von Willebrand factor (VWF)
• gastrointestinal (GI)
• healthcare resource utilization (HCRU)
• Charlson Comorbidity Index (CCI)

Article highlights

• Patients with von Willebrand disease (VWD) and Angiodysplasia (AGD) had significant healthcare resource utilization (HCRU) and clinical burden from recurrent bleeding episodes.

• There was a substantial financial burden that was predominantly driven by hospitalizations.

• Most common diagnostic-related procedures were upper and lower gastrointestinal (GI) screening, colonoscopy, esophagogastroduodenoscopy, and video capsule endoscopy.

• The majority of the patients with VWD and angiodysplasia received pharmacological treatments during the follow-up period, such as desmopressin, VWF concentrates, and aminocaproic acid.

• There may be an opportunity to reduce healthcare costs and burden of illness for VWD and AGD patients by improving the identification, treatment, and prevention of recurrent GI bleeding.

Acknowledgments

Medical writing support was provided by Martin Senecal, MS, of Complete HEOR Solutions, North Wales, PA, USA, and was funded by Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, USA.

Declaration of interest

The authors were supported by Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, U.S.A. N Connell participates in an advisory board and is a consultant to Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, and current holder of equity in publicly traded companies. J Caicedo, M Bullano, N Nieto, and B Sschultz are employees of Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, U.S.A, and current holders of individual Takeda stock/stock options. A Hait and A Gupta are employees of Complete HEOR Solutions which has received financial compensation from Takeda for conducting the study analysis. S Chatterjee was an employee of Complete HEOR Solutions when the study was conducted, which has received financial compensation from Takeda Pharmaceuticals U.S.A., Inc. for conducting the study analysis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

N Connell, J Caicedo, M Bullano, and B Schultz conceptualized and designed the study. N Nieto, S Chatterjee, A Hait, and A Gupta contributed to the data analysis and interpretation of results. All authors contributed to revising the paper critically for intellectual content. All authors approved the final version to be published and agreed to be accountable for all aspects of the work.

Data availability statement

The data that support the findings of this study are available from Merative Marketscan Research Databases. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the corresponding author ([email protected]) with the permission of Merative Marketscan Research Databases.

Presentation

The abstract and poster of « Real-World Analysis of Healthcare Resource Utilization and Costs Among Patients Diagnosed with Von Willebrand disease and Angiodysplasia » was published by the American Society of Hematology in November 2022

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2211270

Additional information

Funding

This paper was funded by Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, USA.