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. 2018 Jul/Aug;24(4):E25-E33.
doi: 10.1097/PHH.0000000000000628.

Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment With Isoniazid Among the Commercially Insured

Erica L Stockbridge  1 , Thaddeus L Miller, Erin K Carlson, Christine Ho
Affiliations

Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment With Isoniazid Among the Commercially Insured

Erica L Stockbridge et al. J Public Health Manag Pract. 2018 Jul/Aug.

Abstract

Context: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector.

Objectives: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims.

Methods: Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed.

Participants: Four million commercially insured individuals 0 to 64 years of age.

Main outcome measures: Six-month and 9-month treatment completion rates for isoniazid LTBI regimens.

Results: There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3%; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9%; confidence interval, 44.5-53.3) completed 9 months or more.

Conclusions: Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Process Identifying Individuals Initiating LTBI Treatment With Isoniazid for Whom Treatment Completion Can Be Assesseda Abbreviations: IGRA, interferon gamma release assay; INH, isoniazid; LTBI, latent tuberculosis infection; TST, tuberculin skin test. aThe process was applied to Optum Impact National Research Database claims data for 4 million commercially insured people. The data represented services from January 2011 through March 2015.
FIGURE 2
FIGURE 2
Illustration of How 18 Months of Each Individuals’ Data Were Used to Identify Latent Tuberculosis Infection Treatment With Isoniazid Abbreviation: INH, isoniazid.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. A strategic plan for the elimination of tuberculosis in the United States. MMWR Suppl. 1989;38(16):269–272. - PubMed
    1. Centers for Disease Control and Prevention. Tuberculosis elimination revisited: obstacles, opportunities, and a renewed commitment. Advisory Council for the Elimination of Tuberculosis (ACET). MMWR Recomm Rep. 1999;48(RR-9):1–13. - PubMed
    1. Institute of Medicine Committee on the Elimination of Tuberculosis in the United States. Ending Neglect: The Elimination of Tuberculosis in the U.S Washington, DC: National Academy of Sciences; 2000.
    1. Salinas JL, Mindra G, Haddad MB, Pratt R, Price SF, Langer AJ. Leveling of tuberculosis incidence—United States, 2013–2015. MMWR Morb Mortal Wkly Rep. 2016;65(11):273–278. - PubMed
    1. Mancuso JD, Diffenderfer JM, Ghassemieh BJ, Horne DJ, Kao TC. The prevalence of latent tuberculosis infection in the United States. Am J Respir Crit Care Med. 2016;194(4):501–509. - PubMed

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