OBJECTIVES: To evaluate the impact of bullous pemphigoid (BP) on healthcare resource utilization (HCRU) and costs in a retrospective analysis of 2015–2019 US administrative health insurance claims data (MarketScan).
METHODS: Patients were included in the BP cohort if they had ≥6 months of continuous health plan enrollment before the first observed BP diagnosis (index date) and ≥1 pharmacy claim for BP therapy within 30 days of index date. The BP cohort was matched to non-BP patients (non-BP cohort) based on demographic and clinical characteristics. Follow-up ran from the index date to either health plan disenrollment or end of study database. All-cause per-patient per month (PPPM) and annual HCRU and associated costs were assessed overall and by care setting.
RESULTS: The BP and non-BP cohorts comprised 1,108 and 4,621 patients, respectively. At baseline, patients (~50% female; mean age: BP 73.6, non-BP 71.1) had similar Charlson Comorbidity Index (CCI) scores (BP 3.25 vs. non-BP 2.80). During follow-up, the BP cohort had a higher CCI score (mean: 4.97 vs. 3.25), and higher PPPM HCRU, resulting in higher mean total PPPM medical encounter costs ($2,801 vs. $2,384) versus baseline. The non-BP cohort had similar PPPM HCRU and associated costs at follow-up versus baseline. Including medication costs, the mean total PPPM cost decreased by $213 during follow-up for the non-BP cohort (baseline $1,566, follow-up $1,353) but increased by $358 for the BP cohort (baseline $2,856, follow-up $3,214). The BP cohort had higher annualized PPPM costs both at baseline (Δ$15,480) and follow-up (Δ$22,332) than the non-BP cohort.
CONCLUSIONS: BP patients had higher disease burden in terms of comorbidities, HCRU, and associated costs than non-BP patients of a similar age. Particularly after diagnosis, BP patients were hospitalized more frequently, possibly due to treatment-associated comorbidities and outcomes. More effective and targeted treatment is needed for BP.
