Brilinta(Ticagrelor) is associated with Lower Hospital Readmission Rates for Percutaneous Cardiovascular Procedures Patients at Cedars Sinai Medical Center based on Real World Evidence Study of Medicare Claims Data

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In Brilinta, Cardiovascular

By: Sara Riascos  Feb. 24, 2022

Background:

Percutaneous Cardiovascular Procedures are 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 payers 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 early use of Brilinta(Ticagrelor) was associated with higher platelet inhibition compared to other drugs in Percutaneous Cardiovascular Procedures Patients.

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 Percutaneous Cardiovascular Procedures Patients at Cedars Sinai Medical Center in Los Angeles, California. 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 Cedars Sinai Medical Center between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Percutaneous Cardiovascular Procedures related codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Percutaneous Cardiovascular Procedures patients who dispensed Brilinta (Ticagrelor) within 7 Days of Hospitalization using Part D drugs claims database
   2. Percutaneous Cardiovascular Procedures patients who did not dispense 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 DRG Diagnosis Codes examined at Cedars Sinai Medical Center. For patients whose primary DRG Diagnosis was “Percutaneous Cardiovascular Procedures With Drug-Eluting Stent Without Major Complication Or Comorbidity (MCC)”(247) and when Brilinta(Ticagrelor) was used within 7 days of hospitalization, the readmission rate was 11.83% compared to the cohort where Brilinta (Ticagrelor) was not used, whose readmission rate was 15.54%. The readmission odds ratio for these cohorts was 0.72. The use of Brilinta (Ticagrelor) was associated with a 28% lower readmission rate when used within 7 days of hospitalization. The full list of studied DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Brilinta (Ticagrelor) at Cedars Sinai Medical Center is shown below.

Primary DRG Diagnosis Code	Primary DRG Diagnosis Code Description	Total Hospitalizations without Brilinta	Readmission Without Brilinta	Readmission Rate without Brilinta	Total Hospitalizations with Brilinta	Readmission with Brilinta	Readmission Rate with Brilinta	Readmission Odds Ratio	Reduction in Readmission with Brilinta (%)	Confidence Interval (-)	Confidence Intervals (+)
247	Percutaneous Cardiovascular Procedures With Drug-Eluting Stent Without Major Complication Or Comorbidity (Mcc)	560

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

DRG CODE	Hospital	Hospitalizations with Percutaneous Cardiovascular Procedures	% of Hospitalizations without Brilinta
247	Cedars Sinai Medical Center	571	98.1%
	Beaumont Hospital	442	97.5%

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Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between 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 Percutaneous Cardiovascular Procedures patients at Cedars Sinai Medical Center. This analysis shows that a significant number of Patients are not dispensed Brilinta (Ticagrelor) after Percutaneous Cardiovascular Procedures hospitalizations at Cedars Sinai Medical Center or major US Hospitals.