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Flowchart of patient selection criteria for HAE study and HCRU population, showing groups based on medication prescriptions, continuous enrolment, and CVAD use, with sample sizes at each step.

Treatment patterns and healthcare resource utilization among patients with hereditary angioedema in the United States

Authors: M A Riedl, A Banerji, M E Manning, E Burrell, N Joshi, D Patel, T Machnig, M H Tai, D J Watson.

Published: Orphanet Journal of Rare Diseases, 2018

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Background

Real-world data on usage and associated outcomes with hereditary angioedema (HAE)-specific medications introduced to the United States (US) market since 2009 are very limited. The purpose of this retrospective study was to evaluate real-world treatment patterns of HAE-specific medications in the US and to assess their impact on healthcare resource utilization (HCRU). This analysis used IMS PharMetrics PlusTM database records (2006-2014) of patients with HAE, ?1 insurance claim for an HAE-specific medication, and continuous insurance enrollment for ?3 months following the first HAE prescription claim.

Results

Of 631 total patients, 434 (68.8%) reported C1-INH(IV) use; 396 (62.8%) reported using ecallantide and/or icatibant. There were 306 episodes of prophylactic use of C1-INH(IV) (defined by continuous refills averaging ?1500 IU/week for ?13 weeks) in 155 patientspatients (5.4%) had a central venous access device (CVAD); of these, 5 (27.7%) required hospitalization and 14 (77.7%) had an ED visit. The adjusted relative risk of hospitalization and/or ED visits for patients with a CVAD was 2.6 (95% CI: 0.17, 39.23) compared to C1-INH(IV) users without a CVAD.

Conclusions

Despite widespread availability of modern HAE medications in the US, we identified a subset of patients requiring long-term prophylaxis who continue to be burdened by frequent rescue medication usage and/or complications related to the use of CVADs for intravenous HAE medication.