The effect of serum urate on gout flares and their associated costs: an administrative claims analysis.

Abstract

BACKGROUND:

Increased serum urate (sUA) levels (> or =6.0 mg/dL) are associated with increased likelihood of acute gout attacks, or "flares."

OBJECTIVES:

Identify gout flares with administrative claims data; examine the relationship between sUA and flares; examine the association between sUA and flare-related costs.

METHODS:

This retrospective administrative claims analysis examined subjects with gout (> or =2 medical claims with ICD-9-CM diagnosis code 274.xx or > or =1 claim with a gout diagnosis and > or =1 pharmacy claim for allopurinol, probenecid, colchicine, or sulfinpyrazone) between January 1, 2002 and March 31, 2004. Each subject was observed during 1-year baseline and 1-year follow-up periods. Gout flares were identified with an algorithm using claims for services associated with flares. Outcomes were sUA (mg/dL) and flare-related health care costs. Logistic regression examined the likelihood of flare; generalized linear modeling regression measured the impact of baseline sUA on flare costs, controlling for demographic and health status variables.

RESULTS:

The study sample comprised 18,243 subjects with mean age of 53.9 years. sUA was available for 4277 (23%) subjects. Sixty-two percent (11,253) of subjects had > or =1 flare. The number of mean, unadjusted flares increased with sUA. Logistic results showed subjects with baseline sUA > or =6.0 relative to sUA <6.0 had 1.3 times the odds of gout flare (P <0.05). Generalized linear modeling results showed that baseline sUA > or =6.0 was associated with 2.1 to 2.2 times higher flare costs than was baseline sUA <6.0 (P <0.05).

CONCLUSIONS:

sUA was a significant predictor both of gout flare and related costs. This highlights the importance of gout management strategies aimed at controlling sUA.

• Authors: Rachel Halpern, Mahesh J Fuldeore, Reema R Mody, Pankaj A Patel, Ted R Mikuls
• Journal: Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 15 Issue 1 Pg. 3-7 (Feb 2009) ISSN: 1536-7355 [Electronic] United States
• PMID: 19125135 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Female
• Gout (economics)
• Health Expenditures
• Humans
• Hyperuricemia (economics)
• Insurance Claim Review
• Male
• Managed Care Programs
• Middle Aged
• Retrospective Studies
• United States
• Young Adult