Healthcare Resource Utilization and Costs Among Patients With Stroke-related Spasticity Before and After Treatment With OnabotulinumtoxinA
Lisa Bloudek1, Kristen Migliaccio-Walle1, David Oliveri2, Amy Tung3, Patrick Gillard3
1Curta Consulting Group, 2Genesis Research, 3AbbVie
To evaluate the impact of onabotulinumtoxinA (onabotA) on healthcare resource utilization (HCRU) and costs in the real world among patients with stroke-related spasticity.
Stroke is the most common cause of upper and lower limb spasticity, for which onabotA is an approved treatment in adults.
Retrospective-claims-analysis used data from the IBM MarketScan® Commercial and Medicare Supplemental Databases. Eligible adult patients had ≥1 onabotA claim for stroke-related spasticity between 1/1/2010 and 06/30/2018 and continuous enrollment for ≥ 12 months pre and post-index date (first onabotA claim). Pre- and post-index period differences in all-cause and spasticity-related HCRU and costs were compared. Effect of time from stroke diagnosis (±180 or ± 365 days) to index date on the pre- and post-index period differences was also assessed.
735 patients met criteria and were included in the study. Compared with the pre-index period, a smaller proportion of patients had ≥1 all-cause ED visit and ≥1 all-cause hospitalization admission in the post-index period (p<0.0001). Among those who had a hospital admission, fewer experienced all-cause hospitalizations in the post-index period (p≤0.0011). Similar reductions in spasticity-related HCRU were also observed between pre- and post-index periods. All-cause costs decreased in the post-index period by 65% (pre-index $140,947; post-index $48,553) (p<0.001), largely driven by a reduction in inpatient costs (pre-index $95,268; post-index $9,752). Patients receiving onabotA saw reductions in all-cause costs in the post-index period (p<0.0001) regardless of stroke diagnosis timing.
All-cause and spasticity-related HCRU and costs significantly decreased in the 12 months following onabotA initiation; onabotA may help to alleviate large economic burdens associated with stroke-related spasticity.