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
Objective:
To evaluate the impact of onabotulinumtoxinA (onabotA) on healthcare resource utilization (HCRU) and costs in the real world among patients with stroke-related spasticity.
Background:
Stroke is the most common cause of upper and lower limb spasticity, for which onabotA is an approved treatment in adults.
Design/Methods:
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.
Results:
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.
Conclusions:
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.