Analyzing Costs Associated With Cushing’s Disease

Reddit   Patients with Cushing’s syndrome—hypercortisolemia from any etiology—manifest a multitude of debilitating physical, metabolic, and psychiatric symptoms. Cush­ing’s disease (CD)—hypercortisolemia resulting from an adrenocorticotropic hormone-secreting pituitary adenoma— is the cause of about 70% of spontaneous Cushing’s syndrome cases. CD occurs more frequently in women, with most cases found in patients aged 25 to 45. Although relatively uncommon, CD has been associated with significant mortality and morbidity. Central obesity, wasting of the extremities, hair loss, facial hirsutism, acne, and easy bruising or fragile skin are among the most common patient complaints. Among the more serious comorbidities associ­ated with CD are: Osteoporosis with pathologic fractures. Immunosuppression with frequent infections. Hypertension, diabetes, and cardiac disease. Psychiatric illness, especially depression. While surgery to remove the adenoma is successful in 65% to 90% of cases and many associated comorbidities improve with resolution of the hypercortisolemia, the medical and psychological effects of CD may persist after the hypercorti­solemia has resolved. A Closer Look at the Economic Burden of Cushing’s Disease In the September 2011 issue of Endocrine Practice, my col­leagues and I had a study published for which we explored the healthcare costs of CD, including its comorbidities, and whether successful treatment improved the economic impact of the disease. Using administrative health insurance data, we compared healthcare resource use and costs among patients with CD with those of patients with non-functioning pitu­itary adenomas (NFPA) and population controls (PC) without pituitary disease. The prevalence of comorbidities and changes in medical costs were analyzed in patients with CD before and after surgical treatment and compared with controls. We found that coding for insurance claims demonstrated comor­bidities...