Period prevalence of chronic pancreatitis diagnosis from 2001-2013 in the commercially insured population of the United States

Abstract

Background: Prevalence estimates of chronic pancreatitis (CP) in the US are scarce. We aimed to determine the prevalence of CP in the commercially insured population of the US.

Methods: We analyzed the IQVIA Legacy PharMetrics database to calculate the period prevalence of CP from 2001 to 2013 among individuals with ≥1 year of enrollment. CP was defined as ≥1 healthcare contacts associated with a non-ancillary claim for a primary diagnosis of CP (ICD-9-CM 577.1). Prevalence estimates were age- and sex- adjusted to the 2010 US population. Sensitivity analysis was performed by using more stringent criteria: a) 1 claim of CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; b) 1 claim of CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≥3 months before or after the index CP claim]; c) ≥2 claims for CP; and d) ≥2 claims for CP separated by ≥ 6 months.

Results: Of 48.67 million eligible enrollees, 37,061 received the diagnosis of CP (mean age, 51.2 ± 15.2 years; 49% male). The age- and sex- adjusted period prevalence of CP per 100,000 was 73.4 (95% CI, 72.6-74.1), 98.7 (95% CI, 97.7-99.7) for adults and 8.3 (95% CI, 7.8-8.8) for children. Prevalence of CP was slightly higher in males (sex ratio, 1.05) and highest in the age group of 46-55 years (135/100,000). On sensitivity analysis, the prevalence of CP per 100,000 decreased to 60.2, 39.7, 38.8, and 18.8 with each of the alternative definitions.

Conclusion: Prevalence estimates reported in our study provide an insight into the population burden of CP in the US.

Keywords: Burden; Chronic pancreatitis; Epidemiology; Population; Prevalence.

Figure 1:

Age- and sex- adjusted period prevalence of CP diagnosis in the US insured population from 2001–2013 using different definitions – A) entire population, B) Children, C) Adults. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.

Figure 1:

Age- and sex- adjusted period prevalence of CP diagnosis in the US insured population from 2001–2013 using different definitions – A) entire population, B) Children, C) Adults. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.

Figure 1:

Age- and sex- adjusted period prevalence of CP diagnosis in the US insured population from 2001–2013 using different definitions – A) entire population, B) Children, C) Adults. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.

Figure 2:

Age-specific period prevalence of CP diagnosis in the US insured population during 2001–2013 using - A) Primary CP definition, B) Alternative CP definitions. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.

Figure 2:

Age-specific period prevalence of CP diagnosis in the US insured population during 2001–2013 using - A) Primary CP definition, B) Alternative CP definitions. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.

Figure 3:

Gender-specific period prevalence of CP diagnosis in the US insured population during 2001–2013 using different definitions. Primary definition: ≥1 claims for CP; Algorithm I: 1 claim for CP + [≥1 claims of acute pancreatitis (AP), CP or pancreatic cyst/pseudocyst]; Algorithm II: 1 claim for CP + [≥1 claims for AP, CP or pancreatic cyst/pseudocyst in ≤3 months]; Algorithm III: ≥2 claims for CP; Algorithm IV: ≥2 claims for CP separated by ≥6 months.