Healthcare Resource Use in Transthyretin Amyloidosis Cardiomyopathy: An Observational Study in the UK Clinical Setting Using Electronic Health Records
Author(s)
Lisa Anderson, MD1, Aron Buxton, BSc2, Raj Thakkar, BSc(Hons), MBBS, MRCGP, MRCP(UK), FRCP Edin3, Caroline Coats, MBBS, PhD4, Kaushik Guha, MD, FRCP5, Sivatharshini Ramalingam, MBBS, BSc, FRCP, MRCGP, DRCOG, DCM6, Alex Simms, MBChB7, Ruchika Kohli, MD8, He Gao, PhD8, Jil Billy Mamza, MPH, PhD8, Julian D Gillmore, MBBS, MD, PhD9.
1St George's University of London, London, United Kingdom, 2Human Data Sciences, Cardiff, United Kingdom, 3Primary Care Cardiovascular Society, University of Cardiff, Cardiff, United Kingdom, 4Department of Cardiology, Queen Elizabeth University Hospital, Glasgow, United Kingdom, 5Department of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom, 6Royal Brompton Hospital, London, United Kingdom, 7Department of Cardiology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom, 8Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom, 9National Amyloidosis Centre, Division of Medicine, Royal Free Hospital, University College London, London, United Kingdom.
1St George's University of London, London, United Kingdom, 2Human Data Sciences, Cardiff, United Kingdom, 3Primary Care Cardiovascular Society, University of Cardiff, Cardiff, United Kingdom, 4Department of Cardiology, Queen Elizabeth University Hospital, Glasgow, United Kingdom, 5Department of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom, 6Royal Brompton Hospital, London, United Kingdom, 7Department of Cardiology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom, 8Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom, 9National Amyloidosis Centre, Division of Medicine, Royal Free Hospital, University College London, London, United Kingdom.
OBJECTIVES: Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is a condition characterised by the build-up of misfolded transthyretin proteins in the heart. This research aims to estimate healthcare resource utilisation (HCRU) post diagnosis in ATTR-CM patients.
METHODS: In this retrospective observational study, anonymised, linked primary and secondary care data (Clinical Practice Research Datalink [CPRD] and Hospital Episode Statistics [HES]) were used to describe individuals diagnosed with ATTR-CM between January 2004 and March 2023. Demographic and clinical data were summarised using descriptive statistics. HCRU were assessed based on healthcare contacts after the patient’s incident diagnosis until the end of patient follow-up. Available estimates from Healthcare Resource Groups (HRGs) National Costs Grouper and published NHS tariff for GP prescriptions were applied to calculate associated costs, standardised per person-year (PPY).
RESULTS: There were a total of 1,538 patients with ATTR-CM, mean age (standard deviation) 77 (11) years and 67% were male. Median follow-up time was 1.1 (inter-quartile range: 0.3-3.0) years. 1,241 patients (80.7%) had one or more hospital admissions within the first year after diagnosis with an average length of stay of 5.0 days (SD: 13.3 days) per admission. Over time, patients had 24.1 GP contacts, 12.0 outpatient attendances, 4.2 hospital admissions and 1.0 emergency visits PPY, respectively. Number of visits for healthcare contacts were highest in the first year post-diagnosis, decreased in second and third years and plateaued by the end of follow-up. Average costs in the first year after diagnosis were £13,129 per patient (£10,279 [78.3%] and £1,341 [10.2%] from hospital admissions and outpatient attendances, respectively).
CONCLUSIONS: Healthcare resource utilisation was high in ATTR-CM patients, especially in the first year after diagnosis, as reflected by hospital admissions for these patients. This highlights the healthcare burden of ATTR-CM and the need for preventative strategies and early interventions.
METHODS: In this retrospective observational study, anonymised, linked primary and secondary care data (Clinical Practice Research Datalink [CPRD] and Hospital Episode Statistics [HES]) were used to describe individuals diagnosed with ATTR-CM between January 2004 and March 2023. Demographic and clinical data were summarised using descriptive statistics. HCRU were assessed based on healthcare contacts after the patient’s incident diagnosis until the end of patient follow-up. Available estimates from Healthcare Resource Groups (HRGs) National Costs Grouper and published NHS tariff for GP prescriptions were applied to calculate associated costs, standardised per person-year (PPY).
RESULTS: There were a total of 1,538 patients with ATTR-CM, mean age (standard deviation) 77 (11) years and 67% were male. Median follow-up time was 1.1 (inter-quartile range: 0.3-3.0) years. 1,241 patients (80.7%) had one or more hospital admissions within the first year after diagnosis with an average length of stay of 5.0 days (SD: 13.3 days) per admission. Over time, patients had 24.1 GP contacts, 12.0 outpatient attendances, 4.2 hospital admissions and 1.0 emergency visits PPY, respectively. Number of visits for healthcare contacts were highest in the first year post-diagnosis, decreased in second and third years and plateaued by the end of follow-up. Average costs in the first year after diagnosis were £13,129 per patient (£10,279 [78.3%] and £1,341 [10.2%] from hospital admissions and outpatient attendances, respectively).
CONCLUSIONS: Healthcare resource utilisation was high in ATTR-CM patients, especially in the first year after diagnosis, as reflected by hospital admissions for these patients. This highlights the healthcare burden of ATTR-CM and the need for preventative strategies and early interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH121
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)