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Abstract Number: 888

Annual Medical Care Expenditures Among US Adults with Gout, 2005 – 2011

Miriam G. Cisternas1, Louise Murphy2, David J. Pasta3, Edward H. Yelin4 and Charles Helmick5, 1MGC Data Services, Carlsbad, CA, 2Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, 3DMA Corporation, Palo Alto, CA, 4Arthritis Research Group, University of California, San Francisco, San Francisco, CA, 5Arthritis Program, Centers for Disease Control and Prevention, Atlanta, GA

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: gout

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Session Information

Title: Exemplary Abstracts

Session Type: Abstract Submissions (ARHP)

Background/Purpose: Costs associated with gout are of growing interest due to its increasing prevalence, but quantifying those costs has been hampered by its co-occurrence with other highly prevalent, high-cost conditions.  We estimated all-cause medical care expenditures and gout-attributable expenditures among US adults with gout age ≥ 18 years.  

Methods: Using the 2005-2011 Medical Expenditure Panel Survey (MEPS), we identified adults with gout by the presence of ICD-9-CM 274. We estimated annual national total (aggregate) and mean per-person all-cause and gout-attributable expenditures overall and for four expenditure categories: ambulatory care (office-based and hospital outpatient); inpatient care; prescriptions; and other (emergency room visits, home health care, vision aids, dental visits, and medical devices). Gout-attributable expenditures were calculated using multi-stage regression models that adjusted for demographics (age, sex, race, Hispanic ethnicity, and education), health insurance coverage (any private, public only, or none), and a count of nine costly comorbid conditions. All estimates are in 2011 US dollars.

Results: National total all-cause medical care expenditures among the 2.7 million adults reporting gout were $31.8 billion; mean per-person expenditures among US adults with gout were $11,663, compared to $4,643 for all adults.  Across expenditure categories, all-cause mean per-person expenditures were: inpatient ($4,329), ambulatory care ($3,704), prescriptions ($2,497), and other ($1,133).  National gout-attributable expenditures totaled $7.7 billion (mean per person=$2,805) and accounted for 24% ($7.7 billion/$31.8 billion) of all medical expenditures among US adults with gout.  Mean per-person gout-attributable expenditures for inpatient ($1,488) and ambulatory care ($1,349) accounted for essentially all of the attributable expenditures.  Attributable expenditures for prescription and other were less than $100 in magnitude and much less than the estimated error.

Conclusion: Mean per-person all-cause medical expenditures were more than 2.5 times higher among adults with gout compared to the entire adult population. Total annual national medical expenditures attributable to gout were $7.7 billion, accounting for almost one of four dollars spent for medical care of US adults with gout.  The increasing prevalence of gout suggests increasing costs in the future. Raising awareness about recent therapies and guidelines to identify and treat gout at earlier stages and increase compliance may help moderate those costs.


Disclosure:

M. G. Cisternas,
None;

L. Murphy,
None;

D. J. Pasta,
None;

E. H. Yelin,
None;

C. Helmick,
None.

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