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BMC Health Serv Res

Title:		"Evaluation of treatment patterns, healthcare resource utilization and cost of illness for sickle cell disease in Ghana: a private medical insurance claims database study"
Author(s):		Marfo K; Dei-Adomakoh Y; Segbefia C; Dwomoh D; Edgal A; Ampah N; Ramachandrachar BC; Subramanyam K; Natarajan A; Egbujo O; Ataga KI;
Address:		"Novartis Pharma AG, Basel, Switzerland. University of Ghana Medical School, Korle Bu Teaching Hospital, Accra, Ghana. University of Ghana Legon, Accra, Ghana. Novartis Ghana Limited, Accra, Ghana. Nationwide Medical Insurance, Accra, Ghana. IQVIA, 11th Floor Convention Tower, DWTC, Al Saada Street, Dubai, 33083, UAE. BCRamachandrachar@ae.imshealth.com. IQVIA, Bengaluru, India. IQVIA, 11th Floor Convention Tower, DWTC, Al Saada Street, Dubai, 33083, UAE. Novartis Pharmaceuticals Corporation, East Hanover, USA. University of Tennessee Health Science Center, Memphis, USA"
Journal Title:		BMC Health Serv Res
Year:		2023
Volume:		20230921
Issue:		1
Page Number:		1018 -
DOI:		10.1186/s12913-023-09984-6
ISSN/ISBN:		1472-6963 (Electronic) 1472-6963 (Linking)
Abstract:		"BACKGROUND: Sickle cell disease (SCD) is a major public health concern in sub-Saharan Africa, accounting for nearly 75% of the global disease burden. The current analysis evaluated patient characteristics, treatment patterns, healthcare resource utilization (HCRU) and associated costs in patients with SCD based on a Private Medical Insurance Database in Ghana. METHODS: This retrospective longitudinal cohort study was conducted using an e-claims database from Ghana (01 January 2015 to 31 March 2021). Patients were stratified by age (0 month to < 2 years, >/= 2 years to <6 years, >/= 6 years to < 12 years, >/= 12 years to < 16 years; >/=16 years), vaso-occlusive crisis (VOC) (< 1, >/= 1 to < 3, and >/= 3 per year), and continuous enrolment. Study outcomes related to patient characteristics, comorbidities, treatment pattern, HCRU were evaluated for pre- and post-index period (index period was between July 2015 to March 2020). Descriptive analysis was used to analyse different study variables. RESULTS: The study included 2,863 patients (mean age: 20.1 years; Min age: 0; Max age: 83; females 56.1%). Overall, 52.2% (n = 1,495) of SCD patients were >/= 16 years and 17.0% (n = 486) were in the >/= 2 to <6-years age group. The majority of patients aged >/= 16 years (62.5%) in the database did not have reported VOC episodes, 35.9% of patients had 1 to 3 VOCs per year and 1.5% had >/= 3 VOCs per year during the follow-up period. Consultation-based prevalence of SCD was 0.5% [95% confidence interval (CI): 0-1.3%] - 1.4% [CI: 0.6-2.2%]. Malaria, upper respiratory tract infection (URTI) and sepsis were the common complications of SCD. Analgesics were the most frequently prescribed medications followed by anti-infectives, hematinics, and antimalarials. Hydroxyurea, a routine standard of care for SCD was under-utilized. SCD patients had median cost incurred for consultation/hospital services of $11.3 (Interquartile range [IQR] $6.2 - $27.2). For patients with VOC, maximum median cost was incurred for medications ($10.9 [IQR $5.0-$32.6]). Overall median healthcare cost was highest for individuals with >/= 3 VOCs per year during the follow-up period ($166.8 [IQR $70.3-$223.5]). CONCLUSION: In this retrospective private insurance claims database analysis, SCD imposes a significant healthcare burden, especially in patients with VOC. There is a need for reimbursed treatment options that could reduce the long-term burden associated with SCD and VOC"
Keywords:		"Female Humans Young Adult Adult Infant, Newborn Aged, 80 and over Child Ghana/epidemiology Longitudinal Studies Retrospective Studies *Volatile Organic Compounds Patient Acceptance of Health Care *Anemia, Sickle Cell/epidemiology/therapy Cost of Illness *;"
Notes:		"MedlineMarfo, Kwaku Dei-Adomakoh, Yvonne Segbefia, Catherine Dwomoh, Duah Edgal, Adeline Ampah, Nancy Ramachandrachar, Badarinath Chickballapur Subramanyam, Kumaresan Natarajan, Ashok Egbujo, Olufolake Ataga, Kenneth I eng England 2023/09/22 BMC Health Serv Res. 2023 Sep 21; 23(1):1018. doi: 10.1186/s12913-023-09984-6"