Abstract
Panic disorder (PD) is a debilitating condition that drives medical spending at least twice as high as medically matched controls. Excessive utilization of healthcare resources comes from emergency department (ED), medications, diagnostic testing, and physician visits. Freespira is an FDA-cleared digital therapeutic that treats PD and panic attacks (PA) by correcting underlying abnormal respiratory physiology. Efficacy of Freespira has been established in prior studies. This paper reports on a quality improvement program that investigated whether treating PD patients with Freespira would reduce medical costs and improve outcomes over 12-months. Panic symptoms were assessed using the Panic Disorder Severity Scale (PDSS). Pre-and post-treatment insurance claims determined costs. At baseline, mean Clinician Global Impression (CGI-S) was 4.4 (moderately/markedly ill), mean PDSS was 14.4 and mean PA frequency/week was 2 (range 0–5). Immediately post-treatment (week 5) mean CGI-S, PDSS and weekly PA frequency declined to 2.8 (borderline/mildly ill, 4.9 (remission) and 0.2 (range 0–2) respectively, p < 0.001. 82% reported PDSS decrease of ≥ 40% (clinically significant), 86% were PA-free. One-year post treatment mean CGI-S, PDSS and PA remained low at 2.1, 4.4, and 0.3 (range 0–1) respectively. 91% had PDSS decrease of ≥ 40%, 73% were PA-free. The majority of patients were panic attack free and/or reduced their symptoms and avoidance behaviors 1-year post Freespira treatment. Mean overall medical costs were reduced by 35% from $548 to $358 PMPM (per member per month) or an annual reduction of $2280. at 12 months post-treatment. There was a 65% reduction in ED costs from $87 to $30 PMPM. Median pharmacy costs were reduced by 68% from $73 to $23 PMPM.
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Acknowledgements
We thank the research coordinators from AHN, especially Ben Kelly for the work on this QIP. We also thank Rajesh Chitturi (Highmark Health) and Simon Thomas (PAHS) for data management and analysis.
Funding
The VITAL Innovation Program at Highmark Heath provided funding for the study and extracted and analyzed the claims data to obtain cost information. VITAL is a test and learn platform that helps to propel new health solutions into the marketplace by facilitating a real-world test and generating clinical, cost, and experience outcomes. PAHS provided study-related materials and equipment. The authors take responsibility for the integrity of the data and the accuracy of the data analysis.
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Kaplan, A., Mannarino, A.P. & Nickell, P.V. Evaluating the Impact of Freespira on Panic Disorder Patients’ Health Outcomes and Healthcare Costs within the Allegheny Health Network. Appl Psychophysiol Biofeedback 45, 175–181 (2020). https://doi.org/10.1007/s10484-020-09465-0
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DOI: https://doi.org/10.1007/s10484-020-09465-0