(311) Sickle Cell Disease: Comorbidities, Treatment Patterns, and Healthcare Resource Utilization

Background: Sickle cell disease (SCD) is a genetic condition that results in abnormal hemoglobin, a consistent shortage of red blood cells, and worsening symptomology over time. Given recent innovations in the treatment of SCD, it is important to characterize SCD patients and understand recommended SCD treatment patterns, underlying comorbidities, and associated healthcare resource utilization (HCRU).

Objectives: To describe individuals with SCD and their comorbidities, treatments, and HCRU among health networks in the United States.

Methods: Electronic health record data from 2017 to 2024 from the OMNY Health real-world data platform were accessed. Prescription administrations or orders, procedures, and encounters for patients with an SCD diagnosis code [International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) D57] for patients at least 12 years old at their first encounter. This descriptive analysis reported demographic characteristics at the earliest age of eligibility. After the first encounter, healthcare utilization, clinical conditions, and treatments (hydroxyurea, L-glutamine, voxelotor) were also described.

Results: A total of 10,959 individuals with SCD and 619,286 observations were included in the analysis. Overall, the average age of individuals with SCD was 36.4 years (SD 16.4), and the population was predominantly female (68%). Most patients were African American (81%), followed by white (7%), American Indian/Alaska Native (AIAN; 7%), and other races (5%). Eleven percent of the population identified as Hispanic or Latino. Two-thirds of the population had an emergency room visit, with approximately 7 visits per person during the observation period. High utilization of outpatient services (65%) was observed, with 34.6 outpatient visits per individual. The most common clinical conditions included hypertension (25%), anemia (20%), pain (18%; Chest pain (15%), and Vitamin D deficiency (16%). Hydroxyurea was the most prescribed or administered treatment, given to 1,242 individuals in the study population (14%), followed by voxelotor (1%) and L-glutamine ( < 1%).

Conclusions: The disproportionate impact of SCD on African American, AIAN, and Hispanic populations is further compounded by limited treatment options and high HCRU. In addition to debilitating symptoms associated with diagnosis, frequent emergency room and outpatient care visits may be financially burdensome for SCD patients. Future analyses may include assessing recent regulatory approval of gene therapies for SCD and equitable access for minority populations. Broader access to recommended treatments to help prevent crises and pain could be considered to reduce HCRU.