Abstract
Introduction
We developed a claims-based algorithm to identify patients with von Hippel-Lindau
disease–associated renal cell carcinoma (VHL-RCC) from a real-world database and quantified
the prevalence, healthcare resource utilization (HRU), and healthcare costs of VHL-RCC
in the United States (US).
Methods
Using data from the Optum Clinformatics Data Mart (2007-2020), an algorithm was developed
to identify patients with VHL-RCC, who were matched to controls without VHL disease
or RCC. VHL-RCC prevalence in 2019 was estimated and standardized to the US population.
HRU and costs were compared between patients with VHL-RCC versus controls, and costs
associated with tumor reduction procedures were estimated among patients with VHL-RCC.
All costs were adjusted to 2020 US dollars.
Results
VHL-RCC prevalence in the US was 0.92 per 100,000 persons, resulting in 3023 estimated
patients with VHL-RCC in the US. The VHL-RCC cohort (N = 160) incurred higher rates
of inpatient, outpatient, and emergency department visits versus controls (N = 800),
translating to $36,450 more in adjusted all-cause annual healthcare costs. By examining
only claims with an associated RCC diagnosis, it was estimated that patients with
VHL-RCC incurred $21,123 annually in healthcare costs due to RCC management, and the
average cost of nephrectomy was $29,313. Among different complications of RCC-related
tumor reduction procedures, end-stage renal disease was the costliest, which incurred
$65,338 over 6 months postnephrectomy.
Conclusion
VHL-RCC was associated with significant HRU and healthcare costs, including those
related to tumor surgeries. This study underscores the importance of novel therapies
that can reduce the clinical burden and medical intervention costs of VHL-RCC.
Keywords
Abbreviations:
CCI (Charlson Comorbidity Index), CDM (Clinformatics Data Mart), CI (Confidence interval), CNS (Central nervous system), ED (Emergency department), EHR (Electronic health record), FDA (Food and Drug Administration), GEE (Generalized estimating equation), HIPAA (Health Insurance Portability and Accountability Act), HRU (Healthcare resource utilization), ICD (International Classification of Diseases), IRR (Incidence rate ratios), RCC (Renal cell carcinomas), TRP (Treatment reduction procedures), US (United States), VHL (Von Hippel Lindau)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 30, 2022
Accepted:
December 28,
2022
Received in revised form:
December 21,
2022
Received:
October 18,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
