Brilinta/Ticagrelor is associated with lower hospital readmission rates for patients with myocardial infarction based on real-world evidence review of Medicare claims data




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Fund:

Myocardial infarction (MI) is frequently associated with hospital readmission. Readmission is a measure of hospital quality that reflects dimensions of inpatient care quality and also impacts global payer programs such as the CMS Star Rating Program, HRRP and value-based purchases. Brilinta/Ticagrelor is an oral antiplatelet drug prescribed by doctors to reduce the risk of having or dying from a heart attack or stroke. Studieshave shown that the use of Brilinta/Ticagrelor reduces the risk of death from vascular causes, myocardial infarction and stroke. Brilinta is also approved in more than 110 countries to prevent atherothrombotic events after myocardial infarction. Dexur’s analysis of real-world evidence based on Medicare claims data showed that use of Brilinta/Ticagrelor within 7 days of hospitalization was associated with lower hospital readmission rates for patients with myocardial infarction (MI). Reducing readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an entity licensed to perform Medicare claims data analysis, which it uses to perform quality outcome analysis. Dexur has published several articles with Harvard Medical School on topics related to quality outcomes. Dexur’s analysis of medications and their impact on quality outcomes, such as readmissions and mortality, is used by hospitals, IDNs and ACOs to implement best practices and manage risk factors based on real-world evidence.

Methods :

We conducted a retrospective study using Dexur’s analysis of real-world Medicare claims data, for hospitalizations between January 2019 and September 2019. Our methodological criteria were as follows:

  1. Inclusion criteria: selected medical hospitalizations with primary diagnosis with MI codes (listed in the table below)

  2. Selected population stratified into cohorts

    1. IM patients who dispensed Brilinta/Ticagrelor within 7 days of hospitalization using the Part D Drug Claims Database

    2. MI patients who have not dispensed Brilinta/Ticagrelor within 7 days of hospitalization

  3. 30-day readmission rates were analyzed for both population cohorts

Results:

Overall, Brilinta/Ticagrelor was associated with lower hospital readmission rates for all ICD primary diagnosis codes examined. For patients with a primary ICD diagnosis of “Non-ST-segment elevation myocardial infarction (NSTEMI)” (I214) and when Brilinta/Ticagrelor was used within 7 days of hospitalization, the readmission rate was 20 .07% compared to the cohort where Brilinta/Ticagrelor was not used. used, whose readmission rate was 28.43%. The odds ratio of readmission for these cohorts was 0.63. Brilinta/Ticagrelor use was associated with a 37% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmissions with Brilinta/Ticagrelor is shown below.

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Conclusion:

According to data analysis of actual evidence from health insurance claims, for hospitalizations between January 2019 and September 2019, use of Brilinta/Ticagrelor within 7 days of hospitalization may result in substantial reductions in rates of hospital readmission of patients with myocardial infarction.