(180) Impact of the COVID-19 Pandemic on Assessing Incidence and Healthcare Resource Use of Myasthenia Gravis, Parkinson's Disease, and Hidradenitis Suppurativa Patients in the United States

Publication Number: 854

Background: The COVID-19 pandemic led to a global health crisis that has significantly impacted the clinical management of patients due to changes in healthcare organization and healthcare seeking behavior of patients.

Objectives: We aim to describe the impact of the COVID-19 pandemic and lockdown on information collected in a US claims database for 3 diseases: generalized myasthenia gravis (MG), Parkinson's disease (PD) and hidradenitis suppurativa (HS).

Methods: This is a claims analysis of changes in incidence rates, and 6-month healthcare resource utilization and costs of patients diagnosed with MG, PD or HS between 01 January 2018 and 31 December 2020, using IBM MarketScan Commercial, Medicare and Medicaid Supplemental Database. Cohort entry was the incident diagnosis of the disease with follow-up until the earliest of disenrollment, 183 days, study period end. Descriptive analyses were stratified on lockdown coverage of the follow-up period: pre-lockdown (cohort entry: January 01, 2018 - September 14, 2019), interim period (cohort entry: September 15, 2019 - March 14, 2020) and post-lockdown (cohort entry: March 15, 2020 – December 31, 2020). To assess the impact of the lockdown on incidence and visits, an interrupted time series methodology was conducted using generalized least-square regression model across bi-weekly incidence rates and inpatient/outpatient visits (from January 2018 to December 2020). The period of 15-21 March 2020 was defined as the intervention period. All analyses were conducted separately by disease.

Results: There were 5,946 MG patients, 66,653 HS patients and 27,186 PD patients newly identified from January 2018 until December 2020. Incidence rates of MG, PD and HS dropped slightly post-lockdown (Q2 2020) and returned to prior trend in Q3 2020. Baseline characteristics of patients were mostly similar across the three time periods. Median time to disenrollment dropped among patients identified in the interim period: 91-98 days pre-lockdown, 68-71 days interim, 80-104 days post-lockdown. Time to first treatment remained stable post-lockdown. A clear shift to telehealth visits was observed post-lockdown. Six-month all-cause medical costs (inpatient and outpatient costs) dropped slightly for patients identified during the interim period. For MG patients, all-cause medical costs increased among patients identified post-lockdown.

Conclusions: Our findings suggest an impact of US lockdown on the diagnosis of MG, PD and HS while telehealth visits increased post-lockdown. Treatment initiation was not impacted by the lockdown. As expected, a medical costs drop was noted among patients with a follow-up period covering early 2020 pandemic.