Long Term Healthcare Costs and Utilization Among Patients with Non Obstructive Hypertrophic Cardiomyopathy
Author(s)
Nosheen Reza, MD, FACC, FHFSA1, Mike B. Butzner, Jr., DrPH, MPH2, Kirti Batra, MBA3, Qiana Amos, PhD, MPH4, Ami Buikema, MPH4, Paulos Gebrehiwet, PhD2, Sanatan Shreay, PhD, MS2, Anjali T Owens, MD1.
1Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania & the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA, 2HEOR, Cytokinetics, Inc., South San Francisco, CA, USA, 3Optum LifeSciences, Eden Prarie, MN, USA, 4HEOR, Optum LifeSciences, Eden Prarie, MN, USA.
1Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania & the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA, 2HEOR, Cytokinetics, Inc., South San Francisco, CA, USA, 3Optum LifeSciences, Eden Prarie, MN, USA, 4HEOR, Optum LifeSciences, Eden Prarie, MN, USA.
OBJECTIVES: There is limited evidence on the economic burden for patients with non-obstructive hypertrophic cardiomyopathy (nHCM). We analyzed cumulative healthcare resource utilization (HRU) and costs for patients with nHCM over a 5-year follow-up period.
METHODS: Retrospective cohort study of adults (≥18 years) diagnosed with nHCM (January 2013- December 2021) in Optum’s claims and electronic medical record data. Patients had ≥2 claims (first= index date) with a diagnosis code for nHCM (ICD-9/10) at least 30 days apart, 6-months pre index and 5-years follow-up. Cardiovascular (CV)-related cumulative HRU and costs (CPI 2022) were reported as mean [SD], including medical (ambulatory: office visit, outpatient [OP] visits; emergency room [ER] visit; inpatient admissions (IA); length of stay [LOS]; other medical costs) and pharmacy.
RESULTS: Among 3,652 nHCM patients (46% female; mean age 60.6 ± 16.2 years; 74.2% non-Hispanic White; 50% commercial insurance), 89.1% had an ambulatory visit (80.3% office visit, 53.5% OP visits) and 38.0% had a prescription fill. Almost a quarter of patients (23.2%) had an ER visit and 29.6% of patients had an IA over the 5-year follow-up. Cumulative 5-year mean ambulatory visits were 11.2 [13.9] (office visits: 7.3 [9.4], OP visits: 4.0 [8.6]), ER visits 0.5 [1.5], IA 0.7 [2.3], and LOS 7.8 [38.2] days. This translated to a cumulative 5-year total mean CV cost (medical + pharmacy) of $43,533 [$101,631]. Medical costs (total= $43,328 [$101,600]) included total mean ambulatory $9,703 [$25,527] (office visit: $1,447 [$3,752]; OP visit: $8,256 [$24,721]), ER visits $488 [$2,057], IA $27,298 [$88,547], and other medical costs $5,839 [$18,544]. Pharmacy cost over 5-years was $205 [$927].
CONCLUSIONS: Patients with nHCM experience significant HRU leading to increased costs of care, with almost a quarter of patients having an ER visit and IA. Innovative treatment options to reduce this economic burden and improve patient outcomes are urgently needed for patients with nHCM.
METHODS: Retrospective cohort study of adults (≥18 years) diagnosed with nHCM (January 2013- December 2021) in Optum’s claims and electronic medical record data. Patients had ≥2 claims (first= index date) with a diagnosis code for nHCM (ICD-9/10) at least 30 days apart, 6-months pre index and 5-years follow-up. Cardiovascular (CV)-related cumulative HRU and costs (CPI 2022) were reported as mean [SD], including medical (ambulatory: office visit, outpatient [OP] visits; emergency room [ER] visit; inpatient admissions (IA); length of stay [LOS]; other medical costs) and pharmacy.
RESULTS: Among 3,652 nHCM patients (46% female; mean age 60.6 ± 16.2 years; 74.2% non-Hispanic White; 50% commercial insurance), 89.1% had an ambulatory visit (80.3% office visit, 53.5% OP visits) and 38.0% had a prescription fill. Almost a quarter of patients (23.2%) had an ER visit and 29.6% of patients had an IA over the 5-year follow-up. Cumulative 5-year mean ambulatory visits were 11.2 [13.9] (office visits: 7.3 [9.4], OP visits: 4.0 [8.6]), ER visits 0.5 [1.5], IA 0.7 [2.3], and LOS 7.8 [38.2] days. This translated to a cumulative 5-year total mean CV cost (medical + pharmacy) of $43,533 [$101,631]. Medical costs (total= $43,328 [$101,600]) included total mean ambulatory $9,703 [$25,527] (office visit: $1,447 [$3,752]; OP visit: $8,256 [$24,721]), ER visits $488 [$2,057], IA $27,298 [$88,547], and other medical costs $5,839 [$18,544]. Pharmacy cost over 5-years was $205 [$927].
CONCLUSIONS: Patients with nHCM experience significant HRU leading to increased costs of care, with almost a quarter of patients having an ER visit and IA. Innovative treatment options to reduce this economic burden and improve patient outcomes are urgently needed for patients with nHCM.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
P3
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Rare & Orphan Diseases