BURDEN OF ILLNESS, ANNUAL HEALTHCARE UTILIZATION, AND COSTS ASSOCIATED WITH COMMERCIALLY INSURED PATIENTS WITH CUSHING DISEASE IN THE UNITED STATES

Objective: To describe the burden of illness, healthcare utilization, and costs associated with Cushing disease (CD), a rare disorder resulting from adrenocorticotropic hormone secreting pituitary tumors, in commercially insured patients in the U.S. Methods: Patients with CD were identified in 2010 in the IMS Health PharMetrics and Truven Health Analytics MarketScan claims databases. Because there is no diagnosis code l'or CD, patients were identified with a claim for Cushing syndrome and either benign pituitary adenoma or hypophysectomy. We estimated total and CD-related utilization and costs using pharmacy and medical claims. Results: We identified 685 CD patients (81% female; mean age, 41.7 years; mean ('hanson comorbidity index, 1.6; mean number of chronic conditions, 4.2); 30.5% of the patients had diabetes, 22.5% had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease stroke, 5.5(.74) had kidney stones, and 0.7'7i-) had compression fracture of a vertebra. Patients had a mean of 19.8 of visits per year; 38.4% had inpatient hospitalizations and 34.2% visited the emergency department (ED). Patients had a mean of 3.2 CD-related of visits per year; 26.9% had CD-related hospitalizations, 0.9% had CD-related ED visits, and 36.8% had CD treatments. 1\ lean annual total costs were 534,992 (pharmacy, $3,597; medical costs, $31,395). C[) related costs accounted for $14,310 of total costs (CD treatment costs, $9,353; other CD-related costs, $4,957). Conclusion: cD patients have a high burden of illness. Among CT) patients in this study, 30.5% had diabetes, 22.5'i-) had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease/ stroke, and 5.5c;70 had kidney stones. Patients had 19.8 office visits per year, and >34% of patients were hospitalized. Mean total cost of care was approximately $35,000 per year.