Characterizing Idiopathic Pulmonary Fibrosis Patients Using US Medicare Advantage Health Plan Claims Data

Optum Research Database - Medicare Advantage Population. Cohort Entry: 01 January 2008 - 30 September 2014
Abbreviations: IPF idiopathic pulmonary fibrosis, NAC N-acetyl cysteine, IQR interquartile range, SD standard deviation, GERD gastroesophageal reflux disease
^aFor privacy reasons, the earliest year of birth in the MAPD is coded as 1927, so no patients in the cohort entry period prior to 2011 can be coded as age ≥ 85. Counts for patients who entered the cohort before October 2011 and whose actual age is ≥ 85 are collapsed into the 75–84 year grouping in this report

Optum Research Database – Medicare Advantage Population. Cohort Entry: 01 January 2008 - 30 September 2014
Abbreviations: IR incidence rate per 1,000 person-years, IQR interquartile range, SD standard deviation, CI confidence interval, IPF idiopathic pulmonary fibrosis, GERD gastroesophageal reflux disease, GI gastrointestinal, MDD major depressive disorder
^aOne of each type counted per day

Optum Research Database – Medicare Advantage Population. Cohort Entry: 01 January 2008 - 30 September 2014
Abbreviations: IPF idiopathic pulmonary fibrosis, SD standard deviation

Optum Research Database – Medicare Advantage Population. Cohort Entry: 01 January 2008 - 30 September 2014
Abbreviations: IPF idiopathic pulmonary fibrosis, CI confidence Interval, GI gastrointestinal, COPDchronic obstructive pulmonary disease, GERD gastroesophageal reflux disease, MDD major depressive disorder
^aPatients with 2+ claims with ICD-9 code of 410.x0 or 410.x1, primary position only. Patients with only one claim with these AMI codes but have claims suggestive of death were classified as AMI cases. Claims must be within 7 days of each other and must be from the inpatient or emergency room setting
^bPatients with an ICD-9-CM code for AMI (410.x0, 410.x1) in the principal (or primary) diagnosis position on at least one facility claim for hospitalization. Claims from emergency departments were not be included in the case identification as they are likely to lead to misclassification
^cICD-9 code 430, 431, 433.x1, or 434.x1, only in the primary or secondary diagnosis position. For patients identified by 430, 431, exclude if the following ICD-9 diagnosis codes are present on the same day: 800.xx-804.xx, 850.xx-854.xx (in any position); or V57.xx (in the primary position)
^dICD-9 code 430, 431, 433.x1 or 434.x1, restricted to the primary diagnosis position on at least 1 facility claim for hospitalization

Optum Research Database – Medicare Advantage Population
Cohort Entry: 01 January 2008 - 30 September 2014
Abbreviations: IR incidence rate per 1,000 person-years, CI confidence Interval, IPF idiopathic pulmonary fibrosis, COPD chronic obstructive pulmonary disease, GERD, gastroesophageal reflux disease, MDD major depressive disorder;
^aThe mean follow-up time was 0.8 years (IPF cohort) and 0.7 years subgroup)
^bOccurrence of one outcome did not preclude the occurrence of another, with the exception of all-cause mortality, which would result in censoring all additional follow-up
^cFor lung transplantation, patients with unilateral lung transplantation during the baseline period could be "at-risk" to receive another unilateral lung transplantation during the follow-up period; however, double lung transplantations during the baseline would preclude subsequent "at-risk" person-time during the follow-up period
^dPatients with 2+ claims with ICD-9 code of 410.x0 or 410.x1, primary position only. Patients with only one claim with these AMI codes but have claims suggestive of death were classified as AMI cases. Claims must be within 7 days of each other and must be from the inpatient or emergency room setting
^ePatients with an ICD-9-CM code for AMI (410.x0, 410.x1) in the principal (or primary) diagnosis position on at least one facility claim for hospitalization. Claims from emergency departments were not be included in the case identification as they are likely to lead to misclassification
^fICD-9 code 430, 431, 433.x1, or 434.x1, only in the primary or secondary diagnosis position. For patients identified by 430, 431, exclude if the following ICD-9 diagnosis codes are present on the same day: 800.xx-804.xx, 850.xx-854.xx (in any position); or V57.xx (in the primary position)
^gICD-9 code 430, 431, 433.x1 or 434.x1, restricted to the primary diagnosis position on at least 1 facility claim for hospitalization

Authors and Disclosures

Kathleen Mortimer¹, Nadine Hartmann², Christine Chan¹, Heather Norman¹, Laura Wallace³ and Cheryl Enger<sup>4*

1</sup>Optum Epidemiology, Boston, MA, USA. ²Boehringer Ingelheim International GmbH, Ingelheim, Germany. ³Boehringer Ingelheim Pharmaceuticals International, Ridgefield, CT, USA. ⁴Optum Epidemiology, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.

* Correspondence
cheryl.enger@optum.com

Authors' contributions
KM, CE, NH, LW contributed to the study concept and design. CC and HN acquired the data. KM drafted the manuscript. CE, NH, LW critically revised the manuscript for important intellectual content. All authors contributed to the analysis and interpretation of data. All authors read and approved the final manuscript.

Competing interests
NH and LW are employees for Boehringer Ingelheim., CE and HN are employees of Optum. KM and CC were employees of Optum at the time this study was conducted. The authors have no conflicts of interest to report