Goldstein et al: Among infants <29 wGA, RSV-related hospitalizations have increased since 20141-4

A NEW study evaluated the risk of RSV hospitalization among infants <29 wGA since 2014¹

Data Source

MarketScan Commercial Claims and Multistate Medicaid databases

Patient Selection Criteria

Infants <1 year CA between July 1, 2011, and June 30, 2016

Included

  • Preterm infants born 29-34 wGA
  • Full-term infants without health problems
    • Commercially insured infants born 29-34 wGA, n=33,667
    • Commercially insured infants born full term, n=668,619
    • Medicaid-insured infants born 29-34 wGA, n=51,439
    • Medicaid-insured infants born full term, n=908,594

 

Excluded

  • Preterm and full-term infants with CLDP, CHD, or other special conditions, such as:
    • Cystic fibrosis
    • Immunodeficiency
    • Congenital anomalies of respiratory system
    • Neuromuscular, immunological, or genetic conditions
    • Organ transplants

 

Outcomes Evaluated

  • RSV hospitalizations were examined using ICD-9-CM and ICD-10-CM codes

ICD-9-CM CODES

ICD-10-CM CODES

RSV infection (079.6) RSV as the cause of diseases classified elsewhere (B974 and J205)
RSV bronchiolitis (466.11) RSV pneumonia (J121)
RSV pneumonia (480.1) Acute bronchiolitis due to RSV (J210)

 

  • Rate ratios were defined as preterm infant risk relative to full-term infant risk

Study Limitations

  • RSV hospitalizations were identified using ICD-9-CM and ICD-10-CM diagnosis codes on inpatient claims; confirmatory laboratory results were not available
  • Utilization of inpatient RSV prophylaxis among infants <3 months of age discharged from their birth hospitalization during the RSV season is underestimated because inpatient RSV prophylaxis is not recorded in claims databases. RSV prophylaxis use prior to discharge would be expected to reduce RSVH rates in infants <3 months of age

Among infants <29 wGA vs term infants, RSV hospitalization rates increased since 2014

Commercially insured infants graph

Relative risk of RSV hospitalization for infants <6 months of age—commercial (N=4701): 1.57 (0.68-3.63) P=0.29
 

Among infants <29 wGA vs term infants, RSV hospitalization rates increased since 2014

Medicaid insured infants

Relative risk of RSV hospitalization for infants <6 months of age—Medicaid (N=9334): 1.68 (1.16-2.02) P<0.01
 

Goldstein et al conclusions:

The risk of RSV hospitalization among infants <29 wGA vs full-term infants was greater in commercially insured and Medicaid-insured preterm infants since 2014

68% higher (P=0.0054) in Medicaid-insured infants

57% numerical increase in commercially insured infants

The greatest increases in RSV hospitalizations occurred among infants <3 months of age and those insured by Medicaid

 

References

  1. Data on file, Sobi, Inc

  2. Goldstein M, Krilov LR, Fergie J, et al. Impact of the 2014 American Academy of Pediatrics guidance on respiratory syncytial virus hospitalization rates for preterm infants <29 weeks gestational age at birth: 2012 to 2016. Poster presented at: Pediatric Academic Societies Meeting 2019; April 27-30, 2019; Baltimore, MD; Poster 525.

  3. Goldstein M, Krilov LR, Fergie J, et al. Poster presented at: Academy of Managed Care Pharmacy Nexus; October 16-19, 2017; Dallas, TX.

  4. Data on file, Sobi, Inc.

RSV=respiratory syncytial virus; wGA=weeks gestational age; CA=chronological age.

Goldstein et al: Among infants <29 wGA, RSV-related hospitalizations have increased since 20141-4

A NEW study evaluated the risk of RSV hospitalization among infants <29 wGA since 2014¹

Data Source

MarketScan Commercial Claims and Multistate Medicaid databases

Patient Selection Criteria

Infants <1 year CA between July 1, 2011, and June 30, 2016

Included

  • Preterm infants born 29-34 wGA
  • Full-term infants without health problems
    • Commercially insured infants born 29-34 wGA, n=33,667
    • Commercially insured infants born full term, n=668,619
    • Medicaid-insured infants born 29-34 wGA, n=51,439
    • Medicaid-insured infants born full term, n=908,594

 

Excluded

  • Preterm and full-term infants with CLDP, CHD, or other special conditions, such as:
    • Cystic fibrosis
    • Immunodeficiency
    • Congenital anomalies of respiratory system
    • Neuromuscular, immunological, or genetic conditions
    • Organ transplants

 

Outcomes Evaluated

  • RSV hospitalizations were examined using ICD-9-CM and ICD-10-CM codes

ICD-9-CM CODES

ICD-10-CM CODES

RSV infection (079.6) RSV as the cause of diseases classified elsewhere (B974 and J205)
RSV bronchiolitis (466.11) RSV pneumonia (J121)
RSV pneumonia (480.1) Acute bronchiolitis due to RSV (J210)

 

  • Rate ratios were defined as preterm infant risk relative to full-term infant risk

Study Limitations

  • RSV hospitalizations were identified using ICD-9-CM and ICD-10-CM diagnosis codes on inpatient claims; confirmatory laboratory results were not available
  • Utilization of inpatient RSV prophylaxis among infants <3 months of age discharged from their birth hospitalization during the RSV season is underestimated because inpatient RSV prophylaxis is not recorded in claims databases. RSV prophylaxis use prior to discharge would be expected to reduce RSVH rates in infants <3 months of age

Among infants <29 wGA vs term infants, RSV hospitalization rates increased since 2014

Commercially insured infants graph

Relative risk of RSV hospitalization for infants <6 months of age—commercial (N=4701): 1.57 (0.68-3.63) P=0.29
 

Among infants <29 wGA vs term infants, RSV hospitalization rates increased since 2014

Medicaid insured infants

Relative risk of RSV hospitalization for infants <6 months of age—Medicaid (N=9334): 1.68 (1.16-2.02) P<0.01
 

Goldstein et al conclusions:

The risk of RSV hospitalization among infants <29 wGA vs full-term infants was greater in commercially insured and Medicaid-insured preterm infants since 2014

68% higher (P=0.0054) in Medicaid-insured infants

57% numerical increase in commercially insured infants

The greatest increases in RSV hospitalizations occurred among infants <3 months of age and those insured by Medicaid

 

References

  1. Data on file, Sobi, Inc

  2. Goldstein M, Krilov LR, Fergie J, et al. Impact of the 2014 American Academy of Pediatrics guidance on respiratory syncytial virus hospitalization rates for preterm infants <29 weeks gestational age at birth: 2012 to 2016. Poster presented at: Pediatric Academic Societies Meeting 2019; April 27-30, 2019; Baltimore, MD; Poster 525.

  3. Goldstein M, Krilov LR, Fergie J, et al. Poster presented at: Academy of Managed Care Pharmacy Nexus; October 16-19, 2017; Dallas, TX.

  4. Data on file, Sobi, Inc.

RSV=respiratory syncytial virus; wGA=weeks gestational age; CA=chronological age.