Healthcare Resource Utilization of Tafamidis Patients in the United States
Author(s)
Sodam Kim, PharmD1, Kanya Shah, MBA, MS, PharmD2, Robert DiDomenico, Pharm.D., FCCP, FHFSA, FACC2, Aaron N. Winn, MPP, PhD2.
1Graduate student, University of Illinois Chicago, Chicago, IL, USA, 2University of Illinois Chicago, Chicago, IL, USA.
1Graduate student, University of Illinois Chicago, Chicago, IL, USA, 2University of Illinois Chicago, Chicago, IL, USA.
Presentation Documents
OBJECTIVES: Tafamidis is a highly effective but expensive therapy for Transthyretin Amyloid Cardiomyopathy (ATTR-CM). Limited research has assessed inpatient and pharmacy expenditure after approval of tafamidis. This study estimated inpatient healthcare resource utilization and pharmacy expenditure among patients treated with tafamidis.
METHODS: This retrospective cohort study used Merative Health MarketScan Commercial Claims and Medicare Supplemental data. The cohort of adult patients newly prescribed tafamidis were followed until disenrollment or a gap in enrollment exceeding one month after their first tafamidis prescription. Expenditures were measured as total and out-of-pocket payments for inpatient admissions and pharmacy spending for tafamidis dispensing. Average length of stay (LOS) per admission and monthly hospitalizations per patient were also calculated. Cardiovascular (CV)-related events, including cardiac arrhythmias, cardiomyopathy, heart failure, and stroke, were analyzed separately for inpatient total spending, inpatient out-of-pocket payment, LOS, and monthly hospitalization per patient. Mean estimates and 95% confidence intervals (95CI) were calculated assuming normality.
RESULTS: The cohort consisted of 389 patients who initiated tafamidis; in the cohort, 79% were male, 82% were over 65 years-of-age, and 80% had baseline congestive heart failure. Total inpatient spending per admission averaged $33,698 (95CI: $24,244-$43,152), with out-of-pocket costs of $470 ($358-$582). For CV-related events, spending was $34,949 (95CI: $18,271-$51,627) and $646 ($425-$866), for total and out-of-pocket payments, respectively. Total monthly pharmacy spending on tafamidis was $23,923 (95CI: $19,358-$28,488), and monthly out-of-pocket payment was $374 ($257-$491) per patient. There were 0.067 (95CI: 0.052-0.083) and 0.026 (0.017-0.035) admissions per month for all-cause and CV-related events, respectively, on average. The average LOS per admission was 7.4 days (95CI: 6.5-8.4) for all-cause events and 7.6 days (5.9-9.4) for CV-related events.
CONCLUSIONS: Substantial inpatient and pharmacy expenditures were incurred among newly initiated tafamidis users. Further research is warranted to evaluate spending trends over time following the initiation of tafamidis therapy.
METHODS: This retrospective cohort study used Merative Health MarketScan Commercial Claims and Medicare Supplemental data. The cohort of adult patients newly prescribed tafamidis were followed until disenrollment or a gap in enrollment exceeding one month after their first tafamidis prescription. Expenditures were measured as total and out-of-pocket payments for inpatient admissions and pharmacy spending for tafamidis dispensing. Average length of stay (LOS) per admission and monthly hospitalizations per patient were also calculated. Cardiovascular (CV)-related events, including cardiac arrhythmias, cardiomyopathy, heart failure, and stroke, were analyzed separately for inpatient total spending, inpatient out-of-pocket payment, LOS, and monthly hospitalization per patient. Mean estimates and 95% confidence intervals (95CI) were calculated assuming normality.
RESULTS: The cohort consisted of 389 patients who initiated tafamidis; in the cohort, 79% were male, 82% were over 65 years-of-age, and 80% had baseline congestive heart failure. Total inpatient spending per admission averaged $33,698 (95CI: $24,244-$43,152), with out-of-pocket costs of $470 ($358-$582). For CV-related events, spending was $34,949 (95CI: $18,271-$51,627) and $646 ($425-$866), for total and out-of-pocket payments, respectively. Total monthly pharmacy spending on tafamidis was $23,923 (95CI: $19,358-$28,488), and monthly out-of-pocket payment was $374 ($257-$491) per patient. There were 0.067 (95CI: 0.052-0.083) and 0.026 (0.017-0.035) admissions per month for all-cause and CV-related events, respectively, on average. The average LOS per admission was 7.4 days (95CI: 6.5-8.4) for all-cause events and 7.6 days (5.9-9.4) for CV-related events.
CONCLUSIONS: Substantial inpatient and pharmacy expenditures were incurred among newly initiated tafamidis users. Further research is warranted to evaluate spending trends over time following the initiation of tafamidis therapy.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE306
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Rare & Orphan Diseases, STA: Multiple/Other Specialized Treatments