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Comparison of patient characteristics and gout-related health-care resource utilization and costs in patients with frequent versus infrequent gouty arthritis attacks
Rheumatology, 07/27/2012
Saseen JJ et al. – Patients with frequent gouty arthritis are likely to have absolute and/or relative contraindications to gout medications and higher gout–related treatment costs.
Methods- This retrospective study used administrative claims to identify patients with gouty arthritis between 1 July 2005 and 30 June 2010.
- Patients with ≥3 yearly gouty arthritis attacks (frequent gout) were matched 1:2 to patients with <3 yearly attacks (infrequent gout).
- Absolute and relative contraindications to gout medications were evaluated based on product labelling.
- Negative binomial regression and generalized linear models with logarithmic transformation were used for multivariate analysis of overall and gout–related health–care use and cost.
- Mean patient age was 58 years (n = 15669) and 77% were men.
- Compared with patients with infrequent gout, those with frequent gout had higher rates of absolute/relative contraindications to NSAIDs (91.5% vs 78.7%, P < 0.0001), corticosteroids (96.4% vs 87.3%, P < 0.0001), allopurinol (51.0% vs 41.2%, P < 0.0001) and probenecid (13.4% vs 9.4%, P < 0.0001).
- Mean gout–related costs were $889 for frequent gout vs $210 for infrequent gout (P < 0.0001) and all–cause direct costs were $10913 for frequent vs $10685 for infrequent gout (P = ns).
- Mean all–cause outpatient visits among patients with comorbidities compared with those without were 25.8 vs 11.8 among frequent and 19.7 vs 9.0 among infrequent (both P < 0.001) groups.
- Gout–related costs were higher among frequent gout patients with comorbidities than those without comorbidities ($886 vs $513, P = 0.03).
