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. 2020 Feb 11:14:377-387.
doi: 10.2147/OPTH.S233486. eCollection 2020.

Direct and Indirect Costs of Infectious Conjunctivitis in a Commercially Insured Population in the United States

Jay S Pepose  1   2 , Sujata P Sarda  3 , Wendy Y Cheng  4 , Nora McCormick  4 , Hoi Ching Cheung  4 , Priyanka Bobbili  4 , Corey Joseph  3 , Mei Sheng Duh  4
Affiliations

Direct and Indirect Costs of Infectious Conjunctivitis in a Commercially Insured Population in the United States

Jay S Pepose et al. Clin Ophthalmol. .

Abstract

Purpose: To assess the direct and indirect costs of infectious conjunctivitis and quantify medical costs due to conjunctivitis transmission in families.

Methods: In this retrospective claims analysis from the OptumHealth Care Solutions, Inc. database (1998-2016), beneficiaries with or without at least one diagnosis of infectious conjunctivitis were identified. Direct and indirect costs (in 2016 US$) during the 60 days post conjunctivitis diagnosis (or imputed date for controls) were compared using cost differences in linear regressions. For transmission cost analysis, the total cost of each conjunctivitis episode was the sum of the primary episode (seed patient) and the secondary episode (infected family members) costs. A generalized estimating equation model adjusted for seed patient characteristics was used to assess the impact of number and rate of transmissions on episode cost.

Results: Health care resource utilization and direct costs were significantly higher for patients with conjunctivitis (n=1,002,188) versus controls (n=4,877,210): 1.67 all-cause visits per person per month (PPPM) versus 0.79 visits PPPM, respectively; total mean direct cost of $396.04 PPPM versus $289.63 PPPM, respectively. The cost of medically related absenteeism was $105.42 (95% confidence interval [CI], $104.18-$106.75) higher for patients with conjunctivitis than for controls. Episode cost, without transmission due to seed patient, was $669.43 (95% CI, $654.67-$684.85); it increased with each additional infected family member and with increased infection transmission time between family members.

Conclusion: Conjunctivitis was associated with a notable economic burden in terms of direct medical costs and medically related absenteeism. Family health care costs increased with transmission time and with each family member infected with conjunctivitis.

Keywords: charges; costs; health care resource utilization; infectious conjunctivitis; vector transmission.

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Conflict of interest statement

Jay S Pepose is/has been a consultant for AcuFocus, Bausch & Lomb, BRIM Biotech, Johnson & Johnson, Noveome, Shire (a Takeda company), Sun, and TearLab; and is an equity owner of AcuFocus, Mimetogen, Ocunexus, Okogen, and Stuart. Sujata P Sarda is an employee of and owns stock/stock options in Takeda. Wendy Y Cheng, Nora McCormick, Hoi Ching Cheung, Priyanka Bobbili, and Mei Sheng Duh are employees of Analysis Group, Inc., which has received research funding from Shire (a Takeda company). Priyanka Bobbili reports grants from Shire (a Takeda company), during the conduct of the study. Mei Sheng Duh reports grants from Takeda during the conduct of the study. Corey Joseph is an employee of and owns stock/stock options in Takeda. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) Study design scheme. (B) Study design scheme used to compute the cost of transmission of conjunctivitis in families. Note: *The index date for nonconjunctivitis controls was an imputed date based on the distribution of time between the enrollment start date and the index date among patients with conjunctivitis.
Figure 2
Figure 2
Sample selection flowchart. Note: *A 50% sample was used of the 13,020,562 patients identified without conjunctivitis.
Figure 3
Figure 3
Weighted health care resource utilization for patients with conjunctivitis. Abbreviations: CI, confidence interval; ED, emergency department; IRR, incidence rate ratio; PPPM, per person per month.
Figure 4
Figure 4
Weighted mean direct costs of conjunctivitis (in US$). Notes: Significance of difference in costs, conjunctivitis cases versus nonconjunctivitis controls: *P<0.05; †P=0.6240. Abbreviations: ED, emergency department; PPPM, per person per month.
Figure 5
Figure 5
Weighted mean indirect cost of conjunctivitis, inverse probability of treatment weighted. (A) Work-loss days. (B) Work-loss costs (in US$). Abbreviations: PPPM, per person per month.
See this image and copyright information in PMC

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