Brilinta (Ticagrelor) is associated with Lower Hospital Readmission Rates for Myocardial Infarction Patients at Methodist University Hospital based on Real World Evidence Study of Medicare Claims Data

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In Brilinta, Myocardial Infarction

By: Sara Riascos  Mar. 14, 2022

Background:

Myocardial Infarction is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Brilinta (Ticagrelor) is an oral antiplatelet prescribed by doctors to reduce the risk of having, or dying from a heart attack or stroke. Studies have shown that the use of Brilinta (Ticagrelor) reduces the risk of death from vascular causes, myocardial infarctions, and strokes. Brilinta is also approved in more than 110 countries to prevent atherothrombotic events after a myocardial infarction.

Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Brilinta (Ticagrelor) within 7 days of hospitalization was associated with lower hospital readmission rates for Myocardial Infarction Patients at Methodist University Hospital in Memphis, Tennessee. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Methodist University Hospital between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Myocardial Infarction related codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Myocardial Infarction patients dispensed with Brilinta (Ticagrelor) within 7 Days of Hospitalization using Part D drugs claims database
   2. Myocardial Infarction patients not dispensed with 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 Primary ICD Diagnosis Codes examined at Methodist University Hospital. For patients whose primary ICD Diagnosis was “Non-ST elevation (NSTEMI) myocardial infarction” (I214) and when Brilinta (Ticagrelor) was used within 7 days of hospitalization, the readmission rate was 22.95% compared to the cohort where Brilinta (Ticagrelor) was not used, whose readmission rate was 24.88%. The readmission odds ratio for these cohorts was 0.90. The use of Brilinta (Ticagrelor) was associated with a 10% 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 readmission with Brilinta (Ticagrelor) at Methodist University Hospital is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without Brilinta (Ticagrelor)	Readmission Without Brilinta (Ticagrelor)	Readmission Rate without Brilinta (Ticagrelor)	Total Hospitalizations with Brilinta (Ticagrelor)	Readmission with Brilinta (Ticagrelor)	Readmission Rate with Brilinta (Ticagrelor)	Readmission Odds Ratio	Reduction in Readmission with Brilinta (Ticagrelor) (%)	Confidence Interval (-)	Confidence Intervals (+)
I214	Non-ST elevation (NSTEMI) myocardial infarction	1,001

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Myocardial Infarction were not prescribed Brilinta (Ticagrelor) within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Myocardial Infarction	% of Hospitalizations without Brilinta (Ticagrelor)
I214	Charleston Area Medical Center General Hospital	1,586	98.99%
	Methodist University Hospital	1,015	98.62%
	Yale New Haven Hospital	908	98.35%

​Hospitalizations with Myocardial Infarction = Above Listed ICD Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January January 2017 to September 2019, the use of Brilinta (Ticagrelor) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Myocardial Infarction patients at Methodist University Hospital. This analysis shows that a significant number of Patients are not dispensed Brilinta (Ticagrelor) after Myocardial Infarction hospitalizations at Methodist University Hospital or major US Hospitals.