Clinical and Economic Burden Imposed by Transthyretin Amyloidosis Cardiomyopathy (ATTR-CM) in Belgium
Author(s)
Rucha Vadia, PhD1, Edgard Prihadi, MD2, Pierre Troisfontaines, MD3, Serge Moudio, MD, PhD4, Caroline Verhestraeten, MSc5, Bart Verheyden, PhD6.
1Health Economics and Payer Evidence, Value & Access, AstraZeneca BeLux, Brussels, Belgium, 2Cardiology Department, Ziekenhuis aan de Stroom, Antwerp, Belgium, 3Cardiology Department, Citadelle - Hôpital public de Liège, Liege, Belgium, 4Real-World Evidence Division, Astra Zeneca BeLux, Groot-Bijgaarden, Belgium, 5Medical Affairs Division, AstraZeneca BeLux, Brussels, Belgium, 6Real-World Evidence Division, AstraZeneca BeLux, Brussels, Belgium.
1Health Economics and Payer Evidence, Value & Access, AstraZeneca BeLux, Brussels, Belgium, 2Cardiology Department, Ziekenhuis aan de Stroom, Antwerp, Belgium, 3Cardiology Department, Citadelle - Hôpital public de Liège, Liege, Belgium, 4Real-World Evidence Division, Astra Zeneca BeLux, Groot-Bijgaarden, Belgium, 5Medical Affairs Division, AstraZeneca BeLux, Brussels, Belgium, 6Real-World Evidence Division, AstraZeneca BeLux, Brussels, Belgium.
OBJECTIVES: Despite increased awareness of ATTR-CM, the nation-wide clinical and economic burden imposed by hospitalization is not known in Belgium.
METHODS: An observational, retrospective, longitudinal, nation-wide analysis was conducted in collaboration with the Belgian Federal Public Service (FPS) Health. Minimal hospital data (MHD) from general hospital-admissions between January 2018 and December 2022 were analyzed. An ATTR-CM cohort was defined based on combinations of ICD codes E85.1, E85.4, E85.8 (/E85.82 in 2020-2022) for amyloidosis diagnosis and I43 for CM diagnosis. Costs per hospital-stay were obtained.
RESULTS: Hospital-admissions in the ATTR-CM cohort increased from 1500 to 3200 between 2018 and 2022, driven by older age groups (70+) and predominantly men (67%). The most common main diagnostic codes were cardiovascular, increasing from >50% to >70% over the 5 years. Mean amount of re-admission per patient per year showed a small but decreasing trend from 2.25 in 2018 to 1.75 in 2022. Top 3 in-hospital procedures covered more than half: cardiovascular (21%), gastrointestinal (19%), anatomical (11%), all with increasing numbers over the 5 years. Mean length of stay was about 13 days (SD: 11.8), remaining stable over time. Average total cost per stay was about € 8,178, equaling a total cost for hospitalizations of € 25,5 Mn in 2022. Share of in-hospital pharmaceutical expenditure ranged between 7-14%.
CONCLUSIONS: Despite considered rare disease, ATTR-CM imposes substantial burden on both patients and the healthcare system, illustrated by a growing number of cardiovascular hospitalizations in our cohort. Whereas the resulting burden may not only be due to ATTR-CM, an unmet need is demonstrated in the management of these patients. It remains to be confirmed to what extent new treatment options and improved care for ATTR-CM have potential to minimize this burden such that early diagnosis and treatment lessen the burden on patients as well as on healthcare system.
METHODS: An observational, retrospective, longitudinal, nation-wide analysis was conducted in collaboration with the Belgian Federal Public Service (FPS) Health. Minimal hospital data (MHD) from general hospital-admissions between January 2018 and December 2022 were analyzed. An ATTR-CM cohort was defined based on combinations of ICD codes E85.1, E85.4, E85.8 (/E85.82 in 2020-2022) for amyloidosis diagnosis and I43 for CM diagnosis. Costs per hospital-stay were obtained.
RESULTS: Hospital-admissions in the ATTR-CM cohort increased from 1500 to 3200 between 2018 and 2022, driven by older age groups (70+) and predominantly men (67%). The most common main diagnostic codes were cardiovascular, increasing from >50% to >70% over the 5 years. Mean amount of re-admission per patient per year showed a small but decreasing trend from 2.25 in 2018 to 1.75 in 2022. Top 3 in-hospital procedures covered more than half: cardiovascular (21%), gastrointestinal (19%), anatomical (11%), all with increasing numbers over the 5 years. Mean length of stay was about 13 days (SD: 11.8), remaining stable over time. Average total cost per stay was about € 8,178, equaling a total cost for hospitalizations of € 25,5 Mn in 2022. Share of in-hospital pharmaceutical expenditure ranged between 7-14%.
CONCLUSIONS: Despite considered rare disease, ATTR-CM imposes substantial burden on both patients and the healthcare system, illustrated by a growing number of cardiovascular hospitalizations in our cohort. Whereas the resulting burden may not only be due to ATTR-CM, an unmet need is demonstrated in the management of these patients. It remains to be confirmed to what extent new treatment options and improved care for ATTR-CM have potential to minimize this burden such that early diagnosis and treatment lessen the burden on patients as well as on healthcare system.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE129
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)