Maureen J. Lage

Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder

AbstractIntroduction: The purpose of this retrospective study was to examine the prevalence of comorbidities, resource use, direct medical costs, and the costs associated with missed work for adults diagnosed with attention-deficit hyperactivity disorder (ADHD). Study design: From a large claims database that captures inpatient, outpatient and prescription drug services, individuals diagnosed with ADHD between the years 1999 and 2001 were retrospectively identified. The ADHD cohort (n = 2252) were matched with a non-ADHD cohort (n = 2252) on a 1: 1 ratio, based upon age, gender, metropolitan statistical area and type of insurance coverage. The ADHD cohort was compared with the non-ADHD cohort for differences in comorbidities and direct medical costs (inpatient, outpatient and prescription drug costs) using year 2001 prices.Using data from six Fortune 200 employers, time missed from work and costs associated with absenteeism, short-term disability and worker’s compensation was examined for a subsample (n = 354) of the employees diagnosed with ADHD.Chi-square and t-statistics were used to compare the ADHD population with the control group with regards to comorbidites and service use. Analysis of covariance and multivariate regressions were used to examine differences in days missed from work, direct medical costs and costs associated with missed work. Results: Adults diagnosed with ADHD were significantly more likely to have a comorbid diagnosis of asthma (p = 0.0014), anxiety (p < 0.0001), bipolar disorder (p < 0.0001), depression (p < 0.0001), drug or alcohol abuse (p < 0.0001), antisocial disorder (p = 0.0081) or oppositional disorder (p = 0.0022) compared with the control group. Controlling for the impact of comorbidities, adults diagnosed with ADHD had significantly higher outpatient costs (

The association between diabetes related medical costs and glycemic control: A retrospective analysis

US3009 vs

Olanzapine versus risperidone in the treatment of schizophrenia : a comparison of costs among Texas Medicaid recipients.

US1492; p < 0.0001), inpatient costs (

Burden of a Multiple Sclerosis Relapse

US1259 vs

Resource use among patients with diabetes, diabetic neuropathy, or diabetes with depression

US514; p < 0.0001), prescription drug costs (

Trends in the prescription of antidiabetic medications in France: evidence from primary care physicians.

US1673 vs

A comparison of costs among patients with type 2 diabetes mellitus who initiated therapy with exenatide or insulin glargine.

US1008; p < 0.0001), and total medical costs (

Glatiramer acetate and interferon beta-1b: a study of outcomes among patients with multiple sclerosis

US5651 vs

Glycemic control among patients with type 2 diabetes who initiate basal insulin: a retrospective cohort study

US2771; p < 0.0001) compared with the non-ADHD cohort. Employees diagnosed with ADHD missed significantly more days due to ‘unofficial’ absences (4.33 days vs 1.13 days; p < 0.0001). Conclusions: The results demonstrate that adults diagnosed with ADHD have a higher prevalence of comorbidities, higher medical costs and more absences than matched individuals without ADHD. These findings suggest that there may be an opportunity for the effective treatment of ADHD to lead to cost-offsets.

Glatiramer acetate and interferon beta-1a for intramuscular administration: a study of outcomes among multiple sclerosis intent-to-treat and persistent-use cohorts

BackgroundThe objective of this research is to quantify the association between direct medical costs attributable to type 2 diabetes and level of glycemic control.MethodsA longitudinal analysis using a large health plan administrative database was performed. The index date was defined as the first date of diabetes diagnosis and individuals had to have at least two HbA1c values post index date in order to be included in the analyses. A total of 10,780 individuals were included in the analyses. Individuals were stratified into groups of good (N = 6,069), fair (N = 3,586), and poor (N = 1,125) glycemic control based upon mean HbA1c values across the study period. Differences between HbA1c groups were analyzed using a generalized linear model (GLM), with differences between groups tested by utilizing z-statistics. The analyses allowed a wide range of factors to affect costs.Results42.1% of those treated only with oral agents, 66.1% of those treated with oral agents and insulin, and 57.2% of those treated with insulin alone were found to have suboptimal control (defined as fair or poor) throughout the study period (average duration of follow-up was 2.95 years). Results show that direct medical costs attributable to type 2 diabetes were 16% lower for individuals with good glycemic control than for those with fair control (