Table 2.
PPPYa Health Care Resource Utilization and Costs Among Knee Osteoarthritis (OA) Patients and Controls in the Post-Index Periodb
| All-Cause Utilization and Costs | Knee OA Cohort N=510,605 |
Control Cohort N=510,605 |
P Valueg |
|---|---|---|---|
| Inpatient (IP) Admissions | |||
| Patients with an IP admission, n (%) | 112,232 (22.0) | 83,335 (16.3) | <0.001 |
| PPPY count of IP admissions, mean (SD) | 0.27 (2.32) | 0.26 (5.88) | 0.253 |
| PPPY cost of IP admissions, mean (SD) | $8,325 ($146,880) | $8,340 ($454,098) | 0.982 |
| Medianf | $0 | $0 | n/a |
| Total Outpatient (OP) Services | |||
| Patient with any OP service, n (%) | 510,510 (99.9) | 466,250 (91.3) | <0.001 |
| PPPY count of OP services, mean (SD) | 84.47 (105.12) | 45.00 (91.70) | <0.001 |
| PPPY cost of OP services, mean (SD) | $12,571 ($42,205) | $6,465 ($55,352) | <0.001 |
| Medianf | $0 | $2,270 | n/a |
| Emergency Room (ER) Visits | |||
| Patients with an ER visit, n (%) | 146,072 (28.6) | 150,995 (29.6) | <0.001 |
| PPPY count of ER visits, mean (SD) | 0.51 (2.77) | 0.35 (2.31) | <0.001 |
| PPPY cost of ER visits, mean (SD) | $901 ($6,730) | $535 ($8,509) | <0.001 |
| Medianf | $0 | $0 | n/a |
| Physician Office (PO) Visits | |||
| Patients with a PO visit, n (%) | 494,651 (96.9) | 437,620 (85.7) | <0.001 |
| PPPY count of PO visits, mean (SD) | 11.10 (11.86) | 6.07 (8.88) | <0.001 |
| PPPY cost of PO visits, mean (SD) | $1,115 ($1,583) | $551 ($949) | <0.001 |
| Median | $795 | $374 | n/a |
| Other Outpatient (OP) Services | |||
| Patients with any other OP service, n (%) | 504,440 (98.8) | 456,250 (89.4) | <0.001 |
| PPPY count of other OP services, mean (SD) | 68.71 (91.72) | 35.86 (80.56) | <0.001 |
| PPPY cost of other OP services, mean (SD) | $10,555 ($40,964) | $5,378 ($54,280) | <0.001 |
| Median | $4,179 | $1,578 | n/a |
| Outpatient (OP) Pharmacy Claims | |||
| Patients with any OP pharmacy claim, n (%) | 480,155 (94.0) | 430,250 (84.3) | <0.001 |
| PPPY count of OP pharmacy claims, mean (SD) | 29.75 (29.77) | 19.79 (23.19) | <0.001 |
| PPPY cost of OP pharmacy claims, mean (SD) | $3,655 ($12,170) | $2,038 ($6,233) | <0.001 |
| Median | $810 | $486 | n/a |
| PPPY Total Medical Costsc | |||
| Mean (SD) | $20,895 ($66,405) | $14,804 ($201,737) | <0.001 |
| Median | $7,795 | $3,466 | n/a |
| PPPY Total Health Care Costsd | |||
| Mean (SD) | $24,550 ($301,786) | $16,843 ($469,090) | <0.001 |
| Median | $9,330 | $2,494 | n/a |
| Knee-OA-Related Utilization and Costs | Knee OA Cohort N=510,605 |
Control Cohort N=510,605 |
P Valueg |
|---|---|---|---|
| Inpatient (IP) Admissions | |||
| Patients with an IP admission, n (%) | 48,791 (9.6) | n/a | |
| PPPY count of IP admissions, mean (SD) | 0.08 (0.71) | n/a | |
| PPPY cost of IP admissions, mean (SD) | $2,351 ($18,466) | n/a | |
| Medianf | $0 | n/a | |
| Total Outpatient (OP) Services | |||
| Patient with any OP service, n (%) | 506,119 (99.1) | n/a | |
| PPPY count of OP services, mean (SD) | 16.84 (47.56) | n/a | |
| PPPY cost of OP services, mean (SD) | $2,324 ($15,053) | n/a | |
| Median | $622 | n/a | |
| Emergency Room (ER) Visits | |||
| Patients with an ER visit, n (%) | 12,675 (2.5) | n/a | |
| PPPY count of ER visits, mean (SD) | 0.07 (2.03) | n/a | |
| PPPY cost of ER visits, mean (SD) | $85 ($4,387) | n/a | |
| Medianf | $0 | n/a | |
| Physician Office (PO) Visits | |||
| Patients with a PO visit, n (%) | 430,946 (84.4) | n/a | |
| PPPY count of PO visits, mean (SD) | 3.06 (8.56) | n/a | |
| PPPY cost of PO visits, mean (SD) | $334 ($1,103) | n/a | |
| Median | $144 | n/a | |
| Other Outpatient (OP) Services | |||
| Patients with any other OP service, n (%) | 445,605 (87.3) | n/a | |
| PPPY count of other OP services, mean (SD) | 13.35 (40.75) | n/a | |
| PPPY cost of other OP services, mean (SD) | $1,905 ($14,281) | n/a | |
| Median | $350 | n/a | |
| Pharmacotherapies of Intereste | |||
| Prescription Nonselective (NS) NSAID Claims | |||
| Patients with NS NSAIDs at any time, n (%) | 206,556 (40.5) | 100,191 (19.6) | <0.001 |
| Time to NS NSAID claim (in days), mean (SD) | 185.4 (281.1) | 535.5 (491.6) | <0.001 |
| PPPY cost of NS NSAIDs, mean (SD) | $442 ($11,254) | $75 ($1,730) | <0.001 |
| COX-2 Inhibitor Claims | |||
| Patients with COX-2 inhibitors at any time, n (%) | 106,217 (20.8) | 82,289 (16.1) | <0.001 |
| Time to COX-2 inhibitor claim (in days), mean (SD) | 242.8 (312.2) | 479.7 (455.6) | <0.001 |
| PPPY cost of COX-2 inhibitors, mean (SD) | $150 ($512) | $93 ($836) | <0.001 |
| Intra-articular Corticosteroid (IA CS) Claims | |||
| Patients with IA CS at any time, n (%) | 254,792 (49.9) | n/a* | n/a |
| Time to IA CS claim (in days), mean (SD) | 64.0 (199.8) | n/a* | n/a |
| PPPY cost of IA CS, mean (SD) | $616 ($7,337) | n/a* | n/a |
| Corticosteroid (non-IA CS) Claims | |||
| Patients with non-IA CS at any time, n (%) | 346,831 (67.9) | 189,764 (37.2) | <0.001 |
| Time to non-IA CS claim (in days), mean (SD) | 99.5 (201.6) | 418.3 (444.3) | <0.001 |
| PPPY cost of non-IA CS, mean (SD) | $309 ($8,912) | $389 ($55,360) | 0.303 |
| Intra-articular Hyaluronic Acid (IA HA) Claims | |||
| Patients with IA HA at any time, n (%) | 94,113 (18.4) | 119 (0.0) | <0.001 |
| Time to IA HA claim (in days), mean (SD) | 197.8 (293.9) | 538.3 (478.2) | <0.001 |
| PPPY cost of IA HA, mean (SD) | $1,012 ($3,219) | $255 ($381) | <0.001 |
| Non-acute Opioid (>30-Day Supply) Claims | |||
| Patients with non-acute opioids at any time, n (%) | 104,037 (20.4) | 49,787 (9.8) | <0.001 |
| Time to non-acute opioid claim (in days), mean (SD) | 101.3 (181.0) | 197.7 (292.7) | <0.001 |
| PPPY cost of non-acute opioids, mean (SD) | $727 ($4,992) | $516 ($6,571) | <0.001 |
| PPPY Total Medical Costsc | |||
| Mean (SD) | $4,674 ($17,847) | n/a | |
| Median | $644 | n/a | |
| PPPY Total Pharmacotherapies of Interest | |||
| Mean (SD) | $3,255 ($36,226) | $1,329 ($64,879) | |
| Median | $759 | $206 | <0.001 |
Notes: aPPPY, Per patient per year; data is reported as PPPY to standardize outcomes against a variable-length follow-up period; bthe post-index period is of variable length. It starts with the index date and ends with the earliest of inpatient death, end of continuous health plan enrollment, or end of the study period (12/31/2017); ctotal medical costs include the sum of costs for inpatient admissions and outpatient services; dtotal health care costs include the sum of costs for inpatient admission, outpatient services, and outpatient pharmacy claims; epatients receiving the following medications: NSAIDs, COX-2-inhibitors, CS in any form, IA CS injections, HA injections, or opioids (>30-day supply); fcosts are calculated among all knee OA patients in the study population, not just those patients with a particular type of service. Median costs may be $0 when the majority of patients did not have that service. For example, only 22% of patients had an all-cause inpatient admission, so median cost of $0 reflects the fact that patients did not have inpatient admissions, not the cost among patients with an inpatient admission; gstatistical significance was defined a priori as p<0.05; All significant p-values are bolded in table text; n/a*, the study definition of the use of IA CS prevented this treatment modality from being observed within control patients because a diagnosis of knee OA was used to define the injection location.
Abbreviations: N, sample size; SD, standard deviation.