NOVEL Health Strategies Selected for 15 Presentations at ISPOR 2020

NOVEL Health Strategies Team was selected for 15 peer-reviewed presentations at ISPOR 2020, including a PODIUM presentation. All presentations leveraged Real-World Evidence to show treatment trends, resource use and need for new treatments.

Studies cover wide range of topics including Crohn's Disease, UC, IBD, PID, Myeloma, AML, NHL, Beta-Thalassemia, ANCA Vasculitis, hATTR, CAR-Ts, Gout, Uterine Fibroids, Influenza and Narcolepsy.

ISPOR Announcement for PODIUM Presentation by NOVEL Health Strategies

ISPOR Announcement for Other Presentations Led by NOVEL Health Strategies

Study on Uterine Fibroids

Burden of Hospitalizations in Uterine Fibroids (UF) Patients with Low and High Comorbidity Index: A Propensity Score Matched Analysis of In-Patient Claims Database

OBJECTIVES:

To examine trends in morbidity, hospital length and cost of stay in UF patients with low and high comorbidity index.

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with UF. Propensity score matched analysis was conducted to compare mortality hospital, LOS and costs in patients with low and high comorbidity index. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 219,715 hospitalizations with a diagnosis of UF. Approximately 89.4% and 11.6% had comorbidity index of <4 and ≥ 4, respectively. The mean age was 42.9 (SD 10.0) and 55.5 (SD 13.8) in low and high comorbidity groups, respectively. Most common comorbidities (more than 10%) were hypertension (23.1%), chronic pulmonary disease (10.5%) and obesity (18.3%). The propensity score matched hospital LOS was 2.9 and 6.3 days, with a statistically significant difference of 3.4 days (SE 0.27, P<0.05), in low and high comorbidity groups, respectively. The propensity score matched hospital charges were $25,541 and $69,307, with a statistically significant difference of $43,766 (SE $3349, P<0.05), in low and high comorbidity groups, respectively.

CONCLUSIONS: UF patients with high comorbidity index incur significantly longer hospital length of stay and nearly three more costs compared to patients with low comorbidity index. There is a need for better treatment management for UF patients with high comorbidity index.

Study on IBD

Comparison of Burden of Hospitalizations in Inflammatory Bowel Disease (IBD) with and without Colorectal Cancer: A Propensity Score Matched Analysis of In-Patient Claims Database

OBJECTIVES:

To examine trends in hospital length of stay and total costs in IBD patients with and without colorectal cancer (CRC).

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with IBD (identified by ICD-10 codes K50 and K51). Propensity score matched analysis was conducted to compare hospital LOS and costs in IBD patients with and without CRC. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 331,950 hospitalizations with a diagnosis of IBD, of which 3025 also had a diagnosis for CRC. The mean age was 58.2 (SD 15.3) and 51.5 (SD 20.1) in IBD patients with and without CRC, respectively. 40.6% and 55.9% were female in IBD with and without CRC, respectively. Most common comorbidities (more than 10%) were hypertension (31.1%), chronic pulmonary disease (20.2%), renal failure (11.7%), weight loss (12.7%), electrolyte disorder (36.7%) and depression (18.0%). The propensity score matched hospital LOS was 9.0 and 5.4, with a statistically significant difference of 3.6 days (SE 0.28, P<0.05), in IBD patients with and without CRC. The propensity score matched hospital charges were $96,582 and $51,877, with a statistically significant difference of $44,704 (SE $4008, P<0.05), in IBD patients with and without CRC. Predictor variables for hospital LOS and costs were chronic pulmonary disease, colorectal cancer, weight loss, ulcer, coagulopathy and anemia.

CONCLUSIONS: IBD patients with CRC incur significantly longer hospital length of stay and nearly twice the costs compared to patients without CRC diagnosis. There is a need for better treatment management for patients with IBD and CRC.

Study on Primary Immunodeficiency Disease

Mortality, Morbidity, Serious Infections and Burden of Hospitalizations in Primary Immunodeficiency Disease (PID) Patients with Low and High Comorbidity Index: A Propensity Score Matched Analysis of In-Patient Claims Database

OBJECTIVES:

To examine trends in mortality, morbidity, hospital length and cost of stay in PID patients with low and high comorbidity index.

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set was utilized to determine the number of hospital admissions for patients with PID. Propensity score matched analysis was conducted to compare mortality hospital, LOS and costs in patients with low and high comorbidity index. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 114,100 hospitalizations with a diagnosis of PID. Approximately 52% and 48% had comorbidity index of <3 and ≥ 3, respectively. The mean age was 39.9 (SD 25.6) and 61.1 (SD 17.8) in low and high comorbidity groups, respectively. Most common comorbidities were congestive heart failure (16.5%), cardiac arrhythmias (20.3%), hypertension (32.3%), chronic pulmonary disease (32.6%), diabetes (11.3%), renal failure (21.1%), lymphoma (10.0%), rheumatoid arthritis (10.0%) and depression (16.5%). The overall rate of serious infections was 45.3% (39.8% in low versus 47.9% in high comorbidity group, P<0.0001). The propensity score matched hospital LOS was 6.1 and 9.6 days, with a statistically significant difference of 3.5 days (SE 1.29, P<0.05), and hospital charges were $49,896 and $116,801, with a statistically significant difference of $66,905 (SE $20,533, P<0.05), in low and high comorbidity groups, respectively. Mortality rate was 1.9% and 6.3% in low and high comorbidity groups, respectively (P<0.0001).

CONCLUSIONS: PID patients with high comorbidity index incur significantly longer hospital length of stay and more than 2 times the costs and 3 times the mortality compared to patients with low comorbidity index. There is a need for better treatment management for PID patients with high comorbidity index.

Study on AML

Comparison of Burden of Hospitalizations in Acute Myeloid Leukemia with and without Hematopoietic Stem Cell Transplant: A Propensity Score Matched Analysis of In-Patient Claims Database

OBJECTIVES:

To examine trends in hospital length of stay and total costs in AML patients with and without Hematopoietic Stem Cell Transplant (HSCT).

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with AML. Propensity score matched analysis was conducted to compare hospital LOS and costs in AML patients with and without HSCT. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 60,780 hospitalizations with a diagnosis of AML, of which 2205 also had a procedure code for HSCT. The mean age was 58.2 (SD 15.3) and 51.5 (SD 20.1) in AML patients with and without HSCT, respectively. 48.5% and 45.0% were female in AML with and without HSCT, respectively. Most common comorbidities (more than 10%) were congestive heart failure (13.2%), cardiac arrhythmias (20.7%), hypertension (38.2%), chronic pulmonary disease (14.7%), diabetes (12.4% complicated, 7.4% complicated), renal failure (11.5%), coagulopathy (30.1%) and depression (14.7%). The propensity score matched hospital LOS was 31.6 and 12.0, with a statistically significant difference of 19.6 days (SE 0.78, P<0.05), in AML patients with and without HSCT. The propensity score matched hospital charges were $535,339 and $136,177, with a statistically significant difference of $399,161 (SE $13145, P<0.05), in AML patients with and without HSCT. Predictor variables for hospital LOS and costs were HSCT, weight loss, lymphoma, cardiac arrhythmias, ulcer, diabetes with complications and liver disease.

CONCLUSIONS: AML patients with HSCT incur significantly longer hospital length of stay and nearly 4 times the costs compared to patients without HSCT. There is a need for better treatment management for patients with AML undergoing HSCT.

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