{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:39:21Z","timestamp":1783039161489,"version":"3.54.6"},"reference-count":50,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Background: Real-world data regarding the impact of onabotulinumtoxinA on healthcare resource utilization and costs for post-stroke spasticity are scarce.\nObjective: To compare differences in 12-month healthcare resource utilization and costs before and after post-stroke spasticity management including onabotulinumtoxinA.\nMethods: This retrospective claims analysis of IBM MarketScan Commercial and Medicare Supplemental databases included adults with \u2265\u20091 onabotulinumtoxinA claim for post-stroke spasticity (1 January 2010 to 30 June 2018) and continuous enrolment for \u2265\u200912 months pre- and post-index (first onabotulinumtoxinA claim date). All-cause and spasticity-related healthcare resource utilization and costs were compared 12 months pre- and post-index (McNemar\u2019s \u03c72 test or paired t-test). A subgroup analysis assessed effect of stroke-to-index interval on costs.\nResults: Among 735 patients, mean (standard deviation) stroke-date-to-index-date interval was 284.5 (198.8) days. Decreases were observed post-index for mean all-cause outpatient (62.9 vs 60.5; p\u2009\u2264\u20090.05) and emergency department visits (1.1 vs 0.8; p\u2009\u2264\u20090.0001), and hospital admissions (1.5 vs 0.4; p\u2009\u2264\u20090.0001). Increase in prescription fills (43.0 vs 53.7) was seen post-index. Post-index decreases in all-cause (\u201366%) and spasticity-related (\u201351%) costs were driven by reduced inpatient care costs. Findings were consistent regardless of stroke-date-to-index-date interval.\nConclusion: Significant reductions in healthcare resource utilization and costs were observed after 1 year of post-stroke spasticity management including onabotulinumtoxinA. Long-term studies are needed to establish causality.<\/jats:p>","DOI":"10.2340\/jrm.v55.11626","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:31:52Z","timestamp":1698672712000},"page":"jrm11626","source":"Crossref","is-referenced-by-count":5,"title":["Healthcare resource utilization and costs among patients with post-stroke spasticity before and after spasticity management including onabotulinumtoxina"],"prefix":"10.2340","volume":"55","author":[{"given":"Alberto","family":"Esquenazi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Bloudek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Migliaccio-Walle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Oliveri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Tung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Gillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Verduzco-Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"40413","doi-asserted-by":"crossref","unstructured":"Pandyan AD, Gregoric M, Barnes MP, Wood D, Van Wijck F, Burridge J, et al. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil 2005; 27: 2-6.","DOI":"10.1080\/09638280400014576"},{"key":"40414","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/09638280400014576","DOI":"10.1080\/09638280400014576"},{"key":"40415","doi-asserted-by":"crossref","unstructured":"Wissel J, Ri S. Assessment, goal setting, and botulinum neurotoxin a therapy in the management of post-stroke spastic movement disorder: updated perspectives on best practice. Expert Rev Neurother 2022; 22: 27-42.","DOI":"10.1080\/14737175.2021.2021072"},{"key":"40416","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/14737175.2021.2021072","DOI":"10.1080\/14737175.2021.2021072"},{"key":"40417","doi-asserted-by":"crossref","unstructured":"Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, et al. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke 2010; 41: 2016-2020.","DOI":"10.1161\/STROKEAHA.110.581991"},{"key":"40418","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1161\/STROKEAHA.110.581991","DOI":"10.1161\/STROKEAHA.110.581991"},{"key":"40419","doi-asserted-by":"crossref","unstructured":"Wissel J, Schelosky LD, Scott J, Christe W, Faiss JH, Mueller J. Early development of spasticity following stroke: a prospective, observational trial. J Neurol 2010; 257: 1067-1072.","DOI":"10.1007\/s00415-010-5463-1"},{"key":"40420","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s00415-010-5463-1","DOI":"10.1007\/s00415-010-5463-1"},{"key":"40421","doi-asserted-by":"crossref","unstructured":"Lundstr\u00f6m E, Ter\u00e9nt A, Borg J. Prevalence of disabling spasticity 1 year after first-ever stroke. Eur J Neurol 2008; 15: 533-539.","DOI":"10.1111\/j.1468-1331.2008.02114.x"},{"key":"40422","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/j.1468-1331.2008.02114.x","DOI":"10.1111\/j.1468-1331.2008.02114.x"},{"key":"40423","doi-asserted-by":"crossref","unstructured":"Menoux D, Jousse M, Quintaine V, Tlili L, Yelnik AP. Decrease in post-stroke spasticity and shoulder pain prevalence over the last 15 years. Ann Phys Rehabil Med 2019; 62: 403-408.","DOI":"10.1016\/j.rehab.2018.03.003"},{"key":"40424","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.rehab.2018.03.003","DOI":"10.1016\/j.rehab.2018.03.003"},{"key":"40425","doi-asserted-by":"crossref","unstructured":"Katoozian L, Tahan N, Zoghi M, Bakhshayesh B. The onset and frequency of spasticity after first ever stroke. J Natl Med Assoc 2018; 110: 547-552.","DOI":"10.1016\/j.jnma.2018.01.008"},{"key":"40426","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jnma.2018.01.008","DOI":"10.1016\/j.jnma.2018.01.008"},{"key":"40427","doi-asserted-by":"crossref","unstructured":"Hotter B, Padberg I, Liebenau A, Knispel P, Heel S, Steube D, et al. Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist - the Managing Aftercare for Stroke (MAS-I) study. Eur Stroke J 2018; 3: 237-245.","DOI":"10.1177\/2396987318771174"},{"key":"40428","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/2396987318771174","DOI":"10.1177\/2396987318771174"},{"key":"40429","doi-asserted-by":"crossref","unstructured":"Wissel J, Manack A, Brainin M. Toward an epidemiology of poststroke spasticity. Neurology 2013; 80: S13-S19.","DOI":"10.1212\/WNL.0b013e3182762448"},{"key":"40430","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1212\/WNL.0b013e3182762448","DOI":"10.1212\/WNL.0b013e3182762448"},{"key":"40431","doi-asserted-by":"crossref","unstructured":"Lekander I, Willers C, von Euler M, Lilja M, Sunnerhagen KS, Pessah-Rasmussen H, et al. Relationship between functional disability and costs one and two years post stroke. PLoS One 2017; 12: e0174861.","DOI":"10.1371\/journal.pone.0174861"},{"key":"40432","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1371\/journal.pone.0174861","DOI":"10.1371\/journal.pone.0174861"},{"key":"40433","unstructured":"Demaerschalk BM, Hwang HM, Leung G. US cost burden of ischemic stroke: a systematic literature review. Am J Manag Care 2010; 16: 525-533."},{"key":"40434","doi-asserted-by":"crossref","unstructured":"Pucciarelli G, Rebora P, Arisido MW, Ausili D, Simeone S, Vellone E, et al. Direct cost related to stroke: a longitudinal analysis of survivors after discharge from a rehabilitation hospital. J Cardiovasc Nurs 2020; 35: 86-94.","DOI":"10.1097\/JCN.0000000000000620"},{"key":"40435","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/JCN.0000000000000620","DOI":"10.1097\/JCN.0000000000000620"},{"key":"40436","doi-asserted-by":"crossref","unstructured":"Lundstr\u00f6m E, Smits A, Borg J, Ter\u00e9nt A. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event. Stroke 2010; 41: 319-324.","DOI":"10.1161\/STROKEAHA.109.558619"},{"key":"40437","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1161\/STROKEAHA.109.558619","DOI":"10.1161\/STROKEAHA.109.558619"},{"key":"40438","doi-asserted-by":"crossref","unstructured":"Raluy-Callado M, Cox A, MacLachlan S, Bakheit AM, Moore AP, Dinet J, et al. A retrospective study to assess resource utilization and costs in patients with post-stroke spasticity in the United Kingdom. Curr Med Res Opin 2018; 34: 1317-1324.","DOI":"10.1080\/03007995.2018.1447449"},{"key":"40439","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/03007995.2018.1447449","DOI":"10.1080\/03007995.2018.1447449"},{"key":"40440","doi-asserted-by":"crossref","unstructured":"Bavikatte G, Subramanian G, Ashford S, Allison R, Hicklin D, Gill CE, et al. Early identification, intervention and management of post-stroke spasticity: expert consensus recommendations. Prevalence of spasticity in nursing home residents. J Cent Nerv Syst Dis 2021; 13: 11795735211036576.","DOI":"10.1177\/11795735211036576"},{"key":"40441","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/11795735211036576","DOI":"10.1177\/11795735211036576"},{"key":"40442","doi-asserted-by":"crossref","unstructured":"Ganapathy V, Graham GD, DiBonaventura MD, Gillard PJ, Goren A, Zorowitz RD. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity. Clin Interv Aging 2015; 10: 1793-1802.","DOI":"10.2147\/CIA.S91123"},{"key":"40443","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2147\/CIA.S91123","DOI":"10.2147\/CIA.S91123"},{"key":"40444","doi-asserted-by":"crossref","unstructured":"Simpson DM, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS, et al. Practice guideline update summary: botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2016; 86: 1818-1826.","DOI":"10.1212\/WNL.0000000000002560"},{"key":"40445","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1212\/WNL.0000000000002560","DOI":"10.1212\/WNL.0000000000002560"},{"key":"40446","doi-asserted-by":"crossref","unstructured":"Wissel J, Ward AB, Erztgaard P, Bensmail D, Hecht MJ, Lejeune TM, et al. European consensus table on the use of botulinum toxin type A in adult spasticity. J Rehabil Med 2009; 41: 13-25.","DOI":"10.2340\/16501977-0303"},{"key":"40447","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2340\/16501977-0303","DOI":"10.2340\/16501977-0303"},{"key":"40448","doi-asserted-by":"crossref","unstructured":"Rosales RL, Chua-Yap AS. Evidence-based systematic review on the efficacy and safety of botulinum toxin-a therapy in post-stroke spasticity. J Neural Transm (Vienna) 2008; 115: 617-623.","DOI":"10.1007\/s00702-007-0869-3"},{"key":"40449","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s00702-007-0869-3","DOI":"10.1007\/s00702-007-0869-3"},{"key":"40450","doi-asserted-by":"crossref","unstructured":"Shaw LC, Price CI, van Wijck FM, Shackley P, Steen N, Barnes MP, et al. Botulinum toxin for the upper limb after stroke (BoTULS) trial: effect on impairment, activity limitation, and pain. Stroke 2011; 42: 1371-1379.","DOI":"10.1161\/STROKEAHA.110.582197"},{"key":"40451","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1161\/STROKEAHA.110.582197","DOI":"10.1161\/STROKEAHA.110.582197"},{"key":"40452","doi-asserted-by":"crossref","unstructured":"Bhakta BB, Cozens JA, Chamberlain MA, Bamford JM. Impact of botulinum toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial. J Neurol Neurosurg Psychiatry 2000; 69: 217-221.","DOI":"10.1136\/jnnp.69.2.217"},{"key":"40453","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1136\/jnnp.69.2.217","DOI":"10.1136\/jnnp.69.2.217"},{"key":"40454","doi-asserted-by":"crossref","unstructured":"Brashear A, Gordon MF, Elovic E, Kassicieh VD, Marciniak C, Do M, et al. Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after a stroke. N Engl J Med 2002; 347: 395-400.","DOI":"10.1056\/NEJMoa011892"},{"key":"40455","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1056\/NEJMoa011892","DOI":"10.1056\/NEJMoa011892"},{"key":"40456","doi-asserted-by":"crossref","unstructured":"Francisco GE, Jost WH, Bavikatte G, Bandari DS, Tang SFT, Munin MC, et al. Individualized onabotulinumtoxinA treatment for upper limb spasticity resulted in high clinician- and patient-reported satisfaction: long-term observational results from the ASPIRE study. PM R 2020; 12: 1120-1133.","DOI":"10.1002\/pmrj.12328"},{"key":"40457","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/pmrj.12328","DOI":"10.1002\/pmrj.12328"},{"key":"40458","doi-asserted-by":"crossref","unstructured":"Doan QV, Gillard P, Brashear A, Halperin M, Hayward E, Varon S, et al. Cost-effectiveness of onabotulinumtoxinA for the treatment of wrist and hand disability due to upper-limb post-stroke spasticity in Scotland. Eur J Neurol 2013; 20: 773-780.","DOI":"10.1111\/ene.12062"},{"key":"40459","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/ene.12062","DOI":"10.1111\/ene.12062"},{"key":"40460","doi-asserted-by":"crossref","unstructured":"Ward A, Roberts G, Warner J, Gillard S. Cost-effectiveness of botulinum toxin type a in the treatment of post-stroke spasticity. J Rehabil Med 2005; 37: 252-257.","DOI":"10.1080\/16501970510027312"},{"key":"40461","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/16501970510027312","DOI":"10.1080\/16501970510027312"},{"key":"40462","unstructured":"IBM MarketScan Research Databases for life sciences researchers Somers, NY, USA: IBM Corporation; 2021 [Last accessed: 23 October 2023] Available from: https:\/\/www.ibm.com\/downloads\/cas\/OWZWJ0QO."}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/11626\/28852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/11626\/28852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:32:12Z","timestamp":1698672732000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/11626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,30]]},"references-count":50,"URL":"https:\/\/doi.org\/10.2340\/jrm.v55.11626","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,30]]}}}