Feuerstadt, Paul (P);Lu, Mei (M);Terasawa, Emi (E);Terreri, Brian (B);Du, Shawn (S);Pi, Selina (S);Westermeyer, Ben (B);Ayyagari, Rajeev (R);Lembo, Anthony (A);Moshiree, Baharak (B);Boules, Mena (M);Cash, Brooks D (BD);

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Gastro Hep Adv.2025 Mar 24;4(7):100664.doi:10.1016/j.gastha.2025.100664

Abstract

BACKGROUND AND AIMS: Chronic idiopathic constipation (CIC) is associated with substantial health care resource utilization (HCRU) and economic burden; however, real-world evidence on the impact of treatment initiation on HCRU and health care costs are limited. We evaluated HCRU and direct health care costs associated with prucalopride initiation in patients with CIC in the United States.

METHODS: Data were collected between January 1, 2015, and June 30, 2020, from the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases for 690 adults with ≥ 1 prescription fill for prucalopride and ≥ 1 constipation-related diagnosis code. All-cause and constipation-related HCRU (outpatient, emergency room, and inpatient visits) for all patients, and pharmacy and medical health care costs for those aged 18-64 years were assessed 6 months before (baseline) and after (study period) prucalopride initiation. Subpopulations examined were patients with prior CIC medication use and males with CIC.

RESULTS: Compared with baseline, the mean number of any constipation-related outpatient visits (2.26 vs 1.52; < .001) and the proportions of patients with these visits (82.6% vs 58.8%; < .001) significantly decreased after prucalopride initiation. In 564 patients, total constipation-related health care costs significantly increased from baseline during the study period (mean: $1497 vs $2332; < .001), primarily driven by increased pharmacy costs after prucalopride initiation ($621 vs $1751; < .001). Constipation-related medical costs significantly decreased during the study period ($876 vs $580; < .001). Some constipation-related HCRU and health care costs decreased after prucalopride initiation in patients with prior CIC medication use and males.

CONCLUSION: In adults with CIC, constipation-related HCRU and medical costs decreased, while constipation-related health care costs and pharmacy costs increased 6 months after prucalopride initiation.