Annual Economic Burden Associated with Cushing's Disease in the United States

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 88-111-Cushing's Disease & Non-Functioning Hypothalamus-Pituitary Tumors
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-95
Michael S Broder1, Maureen P. Neary*2, Eunice Chang1, William Henry Ludlam2 and Dasha Cherepanov1
1Partnership for Health Analytic Research, Beverly Hills, CA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ
OBJECTIVES: There are limited US data currently available on the economic burden of patients with Cushing’s disease (CD), a rare disorder resulting from adrenocorticotropic hormone secreting pituitary tumor. We examined healthcare utilization and costs associated with CD in US patients.

METHODS: CD patients were identified in 2010 in Thomson Reuters MarketScan Commercial and IMS Health PharMetrics claims databases. Given that no diagnosis code for CD exists, patients were identified with a claim for Cushing’s syndrome and either benign pituitary adenomas or hypophysectomy (adenectomy) and continuous enrollment in the study year. Total and CD-related utilization and costs were estimated using pharmacy and medical claims. CD-related outcomes were determined using claims with primary diagnosis of Cushing’s syndrome, benign pituitary adenoma, or claims with CD treatment (pharmacologic, surgery, or radiotherapy). 

RESULTS: There were 685 CD patients (mean age: 41.7 years; 81% female; mean Charlson-comorbidity: 1.6; mean no. chronic conditions: 4.2); 30.5% (209) patients had diabetes, 22.5% had psychiatric disturbances, 8.6% had osteoporosis, 8% had cardiovascular disease/stroke, 5.5% had kidney stones, and 0.7% had compression fracture of vertebra. Patients had a mean of 19.8 physician office visits/year, and >1/3 had inpatient hospitalizations (38.4%) and emergency department visits (34.2%). Patients had 3.2 CD-related visits/year; 26.9% had CD-related hospitalizations, 0.9% had CD-related emergency department visits, and 36.8% had CD treatments. Mean overall costs were $34,992 (SD: $45,811; median: $18,031): $3,597 (SD: $6,323) from pharmacy and $31,395 (SD: $44,082) from medical costs.  Of the total, $14,310 (SD: $25,161; median: $2,079) were coded as likely CD-related costs, with $9,353 (SD: $19,259) from CD treatment and $4,957 (SD: $11,805) from non-treatment costs.  

CONCLUSIONS: CD patients have a high annual economic burden, demonstrated by hospitalizations and emergency department visits in >34% of patients, 19.8 office visits/patient, and $35,000 in total costs. Direct CD-related costs are likely underestimated for reasons such as the use of primary diagnosis only. A planned future study will estimate the cost of CD by comparing economic outcomes between patients who had and did not have the disease.

Disclosure: MSB: Researcher, Novartis Pharmaceuticals. MPN: Employee, Novartis Pharmaceuticals. EC: Researcher, Novartis Pharmaceuticals. WHL: Employee, Novartis Pharmaceuticals. DC: Researcher, Novartis Pharmaceuticals.

*Please take note of The Endocrine Society's News Embargo Policy at

Sources of Research Support: Funding for this study was provided by Novartis Pharmaceuticals Corporation.