Economic Burden Associated with Major Surgery in Patients with von Willebrand Disease: A United States Retrospective Administrative Database Analysis

Abiola Oladapo; Yanyu Wu; Mei Lu; Sepehr Farahbakhshian; Bruce Ewenstein

doi:10.2147/JBM.S320837

Economic Burden Associated with Major Surgery in Patients with von Willebrand Disease: A United States Retrospective Administrative Database Analysis

J Blood Med. 2021 Aug 7:12:699-708. doi: 10.2147/JBM.S320837. eCollection 2021.

Authors

Abiola Oladapo¹, Yanyu Wu², Mei Lu³, Sepehr Farahbakhshian³, Bruce Ewenstein²

Affiliations

¹ Baxalta US Inc., a Takeda Company, Cambridge, MA, USA.
² Takeda Development Center Americas, Inc., Cambridge, MA, USA.
³ Takeda Development Center Americas, Inc., Lexington, MA, USA.

Abstract

Purpose: To estimate the incremental economic burden of major surgeries in patients with von Willebrand disease (VWD).

Patients and methods: This was a retrospective analysis of the IBM Health MarketScan^® database (2008-2018). Patients with at least two healthcare visits for VWD in the database who had undergone at least one major surgery unrelated to VWD (identified via International Classification of Diseases, Ninth and Tenth Revisions procedure codes) were included. Patients without VWD with major surgeries were selected from a 1% random database sample. All patients had ≥12 months of continuous healthcare plan enrollment before and following their first major surgery. Patients with VWD were matched (1:1) with patients without VWD using propensity score matching. Regression models compared healthcare resource utilization and costs between the matched cohorts over a 12-month period after patients' index major surgery.

Results: After propensity score matching, 2972 pairs were selected. Musculoskeletal and digestive surgeries were the two most common major surgeries (patients with VWD, 39.6% and 25.0%; without VWD, 37.1% and 23.4%, respectively). Patients with VWD were significantly more likely (p<0.0001) to have an inpatient admission (odds ratio = 1.71; 95% confidence interval [CI] 1.52-1.92) or emergency room visit (odds ratio = 1.41; 95% CI 1.25-1.59) than patients without VWD. The numbers of inpatient admissions (incidence rate ratio [IRR] = 1.47; 95% CI 1.35-1.60), emergency room visits (IRR = 1.44; 95% CI 1.31-1.59), and outpatient visits (IRR = 1.16; 95% CI 1.11-1.21) per patient were also significantly greater for patients with VWD than for those without VWD (p<0.0001). Patients with VWD incurred significantly higher (p<0.0001) total healthcare costs (medical and pharmacy) per patient than patients without VWD ($50,733.89 versus $30,154.84, respectively).

Conclusion: Healthcare resource utilization and associated costs among patients undergoing major surgeries were significantly higher for those with VWD than for patients without VWD.

Keywords: bleeding; healthcare costs; healthcare resource utilization; retrospective studies.

Grants and funding

This study was funded by Shire US Inc., a Takeda company, Lexington, MA, USA. The study sponsor was involved with the study design, analysis and interpretation of data, writing of the manuscript, and decision to publish the article.