Burden of illness among patients with dementia-related psychosis

• DOI: 10.18553/jmcp.2021.27.3.367
• Publication Date: 2021-02-27T11:21:24Z
• Authors: Monica Frazer; Victor Abler; Rachel Halpern; Ben Skoog; Nazia Rashid
• Keywords: Aged, 80 and over; Male; Databases, Factual; Health Care Costs; United States; 3. Good health; Cohort Studies; Insurance Claim Review; 03 medical and health sciences; 0302 clinical medicine; Cost of Illness; Psychotic Disorders; Case-Control Studies; Humans; Dementia; Female; Aged; Retrospective Studies

BACKGROUND: More than 5.6 million Americans suffer from dementia, and that number is expected to double by 2060. This comes at a considerable burden the health care system with costs estimated $157-$215 billion in 2010. Depending on dementia type disease progression, approximately 20%-70% of patients experience dementia-related psychosis (DRP), characterized hallucinations and/or delusions resulting worse clinical outcomes greater caregiver compared without DRP. OBJECTIVE: To compare real-world events, resource utilization (HCRU), among matched cohorts DRP versus dementia-only patients. METHODS: retrospective database analysis examined commercial Medicare Advantage Part D enrollees aged ≥ 40 years evidence January 1, 2010, through March 31, 2017. The first observed indicator (≥ 2 diagnoses antipsychotic pharmacy fills) co-occurring or following medication was index date were propensity score 1:1 only based demographics, comorbidities, type, severity, pre-index all-cause HCRU. Continuous plan enrollment 12 months before required. Outcomes included HCRU, costs. RESULTS: A significantly higher percentage had ≥1 diagnosis for behavioral conditions period (depression: 32.4% vs. 22.8%; anxiety: 19.1% 11.5%; insomnia: 9.0% 6.3%; P < 0.001 all comparisons). Diagnoses post-index events more likely including falls/fractures (28.3% 14.1%), neurologic effects (17.7% 12.9%), sedation (15.0% 2.4%), cardiovascular (7.0% 4.1%), extrapyramidal reactions (3.2% 1.7%; Higher percentages an outpatient visit (80.2% 68.9%), emergency (65.0% 36.6%), inpatient stay (47.2% 20.0%) during (P proportions office visit, 48%, 147%, 339%, 286% higher, respectively, only. Compared only, mean total ($21,657 $12,026; 0.001) ($11,852 $3,013; 0.001). CONCLUSIONS: Patients have conditions, HCRU These results reflect unmet need urgency new treatment options reduce substantial economic this population. DISCLOSURES: study funded Acadia Pharmaceuticals, which participated design, interpretation results, critical review manuscript. Abler, Skoog, Rashid employees Pharmaceuticals time conducted. Frazer Halpern Optum conducted conduct study.