Evaluation of Treatment Patterns, Healthcare Resource Utilization and Cost of Illness for Sickle Cell Disease in Ghana: A Private Medical Insurance Claims Database Study

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Abstract Background Sickle cell disease (SCD) is a major public health concern in sub-Saharan Africa, accounting for nearly 75% of the global disease burden. The current analysis evaluated patient characteristics, treatment patterns, healthcare resource utilization and associated costs in patients with SCD, based on a Private Medical Insurance Database in Ghana. Methods This retrospective longitudinal cohort study was conducted using a e-claims database from Ghana (01 January 2015 to 31 March 2021). Patients were stratified by age (0 month to < 2 years, ≥ 2 years to ˂6 years, ≥ 6 years to < 12 years, ≥ 12 years to < 16 years; ≥16 years) and vaso-occlusive crisis (VOC) (< 1, ≥ 1 to < 3, and ≥ 3 per year). Results The study included 2,863 patients (mean age: 20.1 years; Min age: 0; Max age: 83; females 56.1%). Overall, 52.2% (n = 1,495) of SCD patients were ≥ 16 years and 17.0% (n = 486) were in the ≥ 2 to ˂6-years age group. The majority of patients aged ≥ 16 years (62.5%) in the database did not have reported VOC episodes while 35.9% of patients had 1 to 3 VOC episodes per year during the follow-up period. Consultation-based prevalence of SCD was 0.5% [95% confidence interval (CI): 0%-1.3%] − 1.4% [CI: 0.6%-2.2%]. Malaria, upper respiratory tract infection (URTI) and sepsis were the common complications of SCD. Analgesics were the most frequently prescribed medications followed by anti-infectives, hematinics, and antimalarials. SCD patients had median cost incurred for consultation/hospital services of $11.3 (Interquartile range [IQR] $6.2 - $27.2). For patients with VOC, maximum median cost was incurred for medications ($10.9 [IQR $5.0-$32.6]). Overall median healthcare cost was highest for individuals with ≥ 3 VOCs per year ($166.8 [IQR $70.3-$223.5]). Conclusion SCD imposes a significant healthcare burden in Ghana, especially in patients with VOC. There is a need for reimbursed treatment options that could reduce the long-term burden associated with SCD and VOC.

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