Tuberculosis Prevention in the Private Sector

Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment with Isoniazid among the Commercially Insured

Erica Lynn Stockbridge, Thaddeus L. Miller, Erin K. Carlson, Christine Ho

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Context: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. Objectives: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. Methods: Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed. Participants: Four million commercially insured individuals 0 to 64 years of age. Main Outcome Measures: Six-month and 9-month treatment completion rates for isoniazid LTBI regimens. Results: There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3%; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9%; confidence interval, 44.5-53.3) completed 9 months or more. Conclusions: Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.

Original languageEnglish
Pages (from-to)E25-E33
JournalJournal of Public Health Management and Practice
Volume24
Issue number4
DOIs
StatePublished - 1 Jan 2018

Fingerprint

Latent Tuberculosis
Private Sector
Isoniazid
Tuberculosis
Insurance
Public Health
Confidence Intervals
Prescriptions
Outcome Assessment (Health Care)

Keywords

  • administrative data
  • claims data
  • isoniazid
  • latent tuberculosis infection
  • methods
  • treatment completion

Cite this

@article{21d6b99cdb0c4939b24be4c717244812,
title = "Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment with Isoniazid among the Commercially Insured",
abstract = "Context: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. Objectives: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. Methods: Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed. Participants: Four million commercially insured individuals 0 to 64 years of age. Main Outcome Measures: Six-month and 9-month treatment completion rates for isoniazid LTBI regimens. Results: There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3{\%}; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9{\%}; confidence interval, 44.5-53.3) completed 9 months or more. Conclusions: Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.",
keywords = "administrative data, claims data, isoniazid, latent tuberculosis infection, methods, treatment completion",
author = "Stockbridge, {Erica Lynn} and Miller, {Thaddeus L.} and Carlson, {Erin K.} and Christine Ho",
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T2 - Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment with Isoniazid among the Commercially Insured

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AU - Miller, Thaddeus L.

AU - Carlson, Erin K.

AU - Ho, Christine

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Y1 - 2018/1/1

N2 - Context: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. Objectives: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. Methods: Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed. Participants: Four million commercially insured individuals 0 to 64 years of age. Main Outcome Measures: Six-month and 9-month treatment completion rates for isoniazid LTBI regimens. Results: There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3%; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9%; confidence interval, 44.5-53.3) completed 9 months or more. Conclusions: Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.

AB - Context: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. Objectives: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. Methods: Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed. Participants: Four million commercially insured individuals 0 to 64 years of age. Main Outcome Measures: Six-month and 9-month treatment completion rates for isoniazid LTBI regimens. Results: There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3%; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9%; confidence interval, 44.5-53.3) completed 9 months or more. Conclusions: Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.

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VL - 24

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