Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

Table 2 MS charges ^a in 2011

	N	% of Total	Mean [SD] charge per patient ($)	PValue
All patients	15,902	100.0	26,520 [38,478]
By patient characteristics
Gender				<0.001^b
Female	12,100	76.1	26,224 [38,716]
Male	3,801	23.9	27,445 [37,691]
Unknown	1	0.0	90,704 [NA]
Age in years				<0.001
17 or younger	126	0.8	14,142 [40,310]
18 to 25	405	2.6	25,731 [44,296]
26 to 35	2,009	12.6	26,324 [36,224]
36 to 45	4,021	25.3	27,430 [36,866]
46 to 55	5,030	31.6	27,558 [39,653]
56 to 64	3,499	22.0	25,876 [38,022]
65 or older	812	5.1	21,167 [42,005]
Region
Northeast	1,861	11.7	27,035 [38,558]	0.646
Midwest	4,480	28.2	25,820 [32,754]
South	6,730	42.3	26,604 [40,196]
West	2,827	17.8	27,093 [42,457]
Other	4	0.0	23,745 [28,601]
Insurance product				0.032
EPO	2,088	13.1	27,933 [42,360]
HMO	1,474	9.3	24,628 [33,046]
Indemnity	329	2.1	22,127 [39,181]
POS	11,336	71.3	26,648 [38,173]
PPO	641	4.0	26,622 [41,918]
Other	34	0.2	19,353 [28,310]
Charge components	Utilization ^c Mean [SD]		Mean [SD] Cost ($)	% of Total Cost
Inpatient^d	0.48 [2.75]		3,179 [17,860]	12.0
Outpatient^d	6.05 [8.04]		9,355 [24,523]	35.3
Emergency Room^d	0.03 [0.39]		33 [522]	0.1
DMD	3.17 [4.87]		13,953 [21,704]	52.6

^aSum of the charges for (1) medical claims with an MS diagnosis (ICD-9-CM = 340.xx in any diagnosis field or a DRG code for MS and cerebellar ataxia [DRG = 058, 059, or 060]) plus (2) medical or pharmacy claims indicating a DMD (Table 1).
^bExcluding the patient with unknown gender (i.e., t-test for female versus male).
^cNumber of claims. Claims counts for DMDs include both medical and pharmacy claims.
^dCharges for medical claims with an MS diagnosis (ICD-9-CM = 340.xx in any diagnosis field or a DRG code for MS and cerebellar ataxia [DRG = 058, 059, or 060]).
DMD = disease-modifying drug; DRG = Diagnosis-Related Group; EPO = exclusive provider organization; HMO = health maintenance organization; MS = multiple sclerosis; NA = not applicable; POS = point of service; PPO = preferred provider organization; SD = standard deviation.

ISSN: 1472-6963