Health Care Resource Utilization and Costs Among Patients With Severe Hypertriglyceridemia and Acute Pancreatitis or Major Adverse Cardiovascular Events

OBJECTIVES: Describe health care resource utilization (HCRU) and costs among patients with mild-to-moderate triglyceride (TG) levels or severe hypertriglyceridemia (sHTG) and acute pancreatitis- (AP) or major adverse cardiovascular event- (MACE) diagnoses.

METHODS: Retrospective claims study of adult patients with ≥1 diagnostic test for serum/plasma TG between 01 Jan 2016 – 31 Mar 2022 using the Optum Research Database. Patients were assigned to four cohorts: normal TG (35≤TG<150 mg/dL [normal cohort]), mild-to-moderate TG (150≤TG<500 mg/dL), and sHTG (placed into 500≤TG<880 mg/dL or TG≥880 mg/dL sub-cohorts). All-cause HCRU and costs were calculated per-patient-per-month (PPPM), 2021 USD, among patients with AP or MACE-related medical claims.

RESULTS: 134,316 patients across four cohorts were included. Among patients with AP-related diagnoses (n=1,321), mean emergency department (ED) visits were significantly higher for all elevated TG cohorts compared to the normal cohort (all p≤0.01), and mean inpatient admissions were significantly higher for the TG≥880 sub-cohort (p=0.022). Among patients with AP-related diagnoses and cost data (n=1,400), the 500≤TG<880 sub-cohort had significantly higher mean PPPM total costs compared to the normal cohort ($1,014 vs $578; p=0.025). Mean total PPPM costs were highest among patients with AP diagnosis and TG≥880 mg/dL, although not statistically significant ($1,084; p=0.210 vs normal cohort).

Compared to the normal cohort, among patients with MACE-related diagnoses (n=17,315), mean inpatient admissions were significantly higher for the 500≤TG<880 and TG≥880 sub-cohorts (p<0.001 and p=0.027, respectively) with ED visits significantly higher for the 500≤TG<880 sub-cohort (p=0.009). Among patients with MACE-related diagnoses and cost data (n=17,947), both sHTG sub-cohorts had significantly higher mean PPPM total costs ($1,067 and $1,283, vs $767; both p<0.001).

CONCLUSIONS: Among patients with AP or MACE-related diagnoses, those with higher TG levels had higher all-cause HCRU and costs compared to patients with normal levels. These findings demonstrate the need for therapeutic innovation to address elevated TG-related economic burden.