How effective is hydroxyurea in preventing acute care for SCD patients?

How effective is hydroxyurea in preventing acute care for children with sickle cell disease (SCD)? A new study in Pediatrics examined the use of hydroxyurea in children with SCD who were covered by Medicaid.

The researchers used information from the Truven Health Analytics–IBM Watson Health MarketScan Medicaid database covering 2009 to 2015. The cohort included children aged 1 to 19 years who had a diagnosis of SCD between 2009 and 2015. They looked at the changes in hydroxyurea use (as per filled prescription claims) over the study years. Acute care visits, including emergency department visits and hospitalization, were found using billing data.

Over the study period, an average of 5138 children were included each study year. During the study period, the use of hydroxyurea increased from 14.3% in 2009 to 28.2% in 2015 and the acute-care-visit rate dropped from 1.20 acute care visits per person-year in 2009 to 1.04 acute care visits per person-year in 2015. The decrease in acute care visits was found solely in the youngest and oldest age groups and was not found when the researchers examined only children who been continuously enrolled for the entire study period.

The investigators concluded that despite a significant increase in hydroxyurea usage in children with SCD over the course of the study period, a consistent decrease in acute care visits was not found among children with SCD who were insured under Medicaid.