Economic Burden Associated With Nasal Polyposis Recurrence Among Commercially Insured Patients in the United States

Objective. To compare health care resource utilization (HRU) and costs among commercially insured patients with nasal polyposis (NP) with and without recurrence after endoscopic sinus surgery (ESS). Study Design. Retrospective matched cohort study. Setting. Adults with initial ESS or an NP excision after a new NP diagnosis were identified in Optum's Clinformatics Data Mart Database (October 1, 2014-December 31, 2019). Methods. The index date was the date of NP recurrence, identified with a claims-based algorithm for the recurrent cohort, or a random date for the nonrecurrent cohort. Patients in both cohorts were matched 1:1 on baseline characteristics (12 months preindex) via propensity scores and exact matching factors. Annual HRU and costs (2019 US$) were compared between the matched cohorts at 12 months postindex. Results. NP recurrence was identified among 3343 of 16,693 patients with initial ESS; after matching, each cohort comprised 1574 patients (median age, 54 years; 40% female) with similar baseline health care costs (recurrent, $34,420; nonrecurrent, $33,737). At 12 months postindex, the recurrent cohort had higher HRU, including 36% and 51% more outpatient and emergency department visits, respectively (all P < .01). Mean health care costs were $9676 higher in the recurrent cohort ($24,039) relative to the nonrecurrent cohort ($14,363, P < .01). The mean cost difference between cohorts was driven by $8211 in additional outpatient costs, as well as $6062 in additional NP-related outpatient costs, in the recurrent cohort (all P < .01). Conclusion. NP recurrence is associated with a substantial economic burden, which appears to be driven by outpatient services.

Automated summary

This study compared health care resource utilization and costs between patients with nasal polyposis (NP) with and without recurrence after endoscopic sinus surgery (ESS). The results showed that patients with NP recurrence had significantly higher health care resource utilization and costs at 12 months post-surgery, mainly due to increased outpatient costs.