Cyclic vomiting syndrome affects 42 per 100,000 Medicaid beneficiaries, study finds

Within 30 days of diagnosis of cyclic vomiting syndrome, only 32% to 35% of adult patients had prescriptions for prophylactic treatment and 47% to 55% for acute treatment, according to an industry-funded study of U.S. claims databases.

A new study quantified the prevalence of cyclic vomiting syndrome (CVS) among U.S. adults.

The cross-sectional study used claims data from commercial, Medicare, and Medicaid databases in 2019, calculated and stratified by age, sex, region, and race/ethnicity. Patient characteristics were reported among patients with new diagnoses of CVS (i.e., no documented claims for CVS before 2019). CVS was defined as having at least one inpatient and/or two outpatient CVS claims that were 71 days apart. The study was funded by Takeda Development Center Americas, and several authors were consultants or current or former employees. Results were published by the American Journal of Gastroenterology on Jan. 16.

The estimated prevalence of CVS was 16.7 per 100,000 among commercial and Medicare patients and 42.9 per 100,000 patients with Medicaid. The incidence of CVS was estimated to be 10.6 and 26.6 per 100,000, respectively. Both prevalence and incidence rates were higher among women. Many patients had comorbid conditions, most commonly abdominal pain (56% to 64%), anxiety (32% to 39%), depression (26% to 34%), cardiac conditions (39% to 42%), and gastroesophageal reflux disease (30% to 40%). Only 32% to 35% of patients had prescriptions for prophylactic treatment and 47% to 55% for acute treatment within 30 days of diagnosis.

“This study provides the first comprehensive estimates of CVS prevalence and incidence rates using large-sized US administrative claims databases, capturing patients in all health care settings and covered by 3 major insurance types,” the study authors said. They highlighted the finding that most patients were not receiving adequate treatment and noted that given “lack of disease awareness and underdiagnosis of CVS in the medical community,” the estimates of incidence and prevalence may be conservative.

The higher rate of CVS among Medicaid beneficiaries is not surprising “because it is a population with socioeconomic factors susceptible to increased prevalence of chronic disease compared with the general United States (and even with other low-income populations),” said the study authors. They noted that Medicaid patients may face barriers to care. The authors called for education of the medical community about CVS and development of better screening and treatment strategies.