INFLAMMATION AND ECONOMIC BURDEN IN ISRAELI PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) AND CHRONIC KIDNEY DISEASE (CKD): A RETROSPECTIVE COHORT STUDY
Author(s)
Sa'ar Minha, MD1, ALON EISEN, MD2, Ariel ROGUIN, MD, PhD3, Julie Thietje Mortensen, MSc, PhD4, Magnus Fugger, PhD4, alona aharonovich, PhD5, Balamurali Kalyanam, PhD4, Erik Landfeldt, MSc, PhD6, Quratul Ann, PhD7.
1Shamir Medical Center (Assaf Harofeh), Beer Yaakov, Israel, 2Rabin Medical Center, Petah Tikva, Israel, 3Hillel Yaffe Medical Center, Hadera, Israel, 4Novo Nordisk, Søborg, Denmark, 5Novo Nordisk, Modiin, Israel, 6IQVIA, Stockholm, Sweden, 7IQVIA, London, United Kingdom.
1Shamir Medical Center (Assaf Harofeh), Beer Yaakov, Israel, 2Rabin Medical Center, Petah Tikva, Israel, 3Hillel Yaffe Medical Center, Hadera, Israel, 4Novo Nordisk, Søborg, Denmark, 5Novo Nordisk, Modiin, Israel, 6IQVIA, Stockholm, Sweden, 7IQVIA, London, United Kingdom.
OBJECTIVES: To describe healthcare resource utilisation (HCRU) and costs among patients with ASCVD and CKD with and without inflammation in Israel.
METHODS: Retrospective cohort study using electronic medical records from Clalit Health Services (2011-2025). Adults aged ≥25 with incident ASCVD and CKD and ≥1 eligible C-reactive protein (CRP) measurement (index date) were grouped into those with inflammation marker (CRP ≥2 mg/L) and without (CRP <2 mg/L). Eligible CRP measurements were ≤20 mg/L, recorded >30 days after ASCVD/CKD diagnosis outside hospitalisations/emergency visits. Patients with other inflammatory conditions or CRP-modifying treatments were excluded. HCRU and direct medical costs (New Israeli Shekels [NIS]) for patients with and without inflammation were compared using two-sample t, chi-squared, or Poisson rate tests.
RESULTS: Of 23,270 patients (mean age 73.8 years; 56.0% male; median follow-up 33.1 months), 16,225 had inflammation and 7,045 did not. Patients with inflammation more frequently experienced ≥1 hospitalisation (68.2% vs 61.4%), higher mean [SD] annualised rates (1.56 [3.61] vs 0.85 [1.77]), and longer duration of stay (4.63 [8.16] vs 3.93 [6.36] days), all P<0.001. Furthermore, intensive care admissions occurred in 12.0% vs 8.9% (annualised rate not calculated due to incomplete data) and emergency visits in 45.8% vs 43.4% (annualised rate: 0.42 [1.18] vs 0.29 [0.69], P<0.001) of patients with vs without inflammation. Outpatient visits occurred in 91.7% of both groups, with higher annualised rates for patients with inflammation (21.79 [19.86] vs 19.02 [14.54], P<0.001). Diagnostic cardiac CT, and antihypertensive, antidiabetic, antiplatelet, and anticoagulant therapies were used more frequently in patients with inflammation (P<0.001). Mean annualised total direct medical costs (NIS) were higher with inflammation (82,901 [120,556] vs 61,351[93,288]), driven by hospitalisations (90,615 [123,310] vs 69,843 [97,488]; P<0.001).
CONCLUSIONS: Israeli patients with ASCVD and CKD with inflammation had higher HCRU and costs than those without, highlighting the need to identify these high-risk patients and explore tailored therapeutic pathways.
METHODS: Retrospective cohort study using electronic medical records from Clalit Health Services (2011-2025). Adults aged ≥25 with incident ASCVD and CKD and ≥1 eligible C-reactive protein (CRP) measurement (index date) were grouped into those with inflammation marker (CRP ≥2 mg/L) and without (CRP <2 mg/L). Eligible CRP measurements were ≤20 mg/L, recorded >30 days after ASCVD/CKD diagnosis outside hospitalisations/emergency visits. Patients with other inflammatory conditions or CRP-modifying treatments were excluded. HCRU and direct medical costs (New Israeli Shekels [NIS]) for patients with and without inflammation were compared using two-sample t, chi-squared, or Poisson rate tests.
RESULTS: Of 23,270 patients (mean age 73.8 years; 56.0% male; median follow-up 33.1 months), 16,225 had inflammation and 7,045 did not. Patients with inflammation more frequently experienced ≥1 hospitalisation (68.2% vs 61.4%), higher mean [SD] annualised rates (1.56 [3.61] vs 0.85 [1.77]), and longer duration of stay (4.63 [8.16] vs 3.93 [6.36] days), all P<0.001. Furthermore, intensive care admissions occurred in 12.0% vs 8.9% (annualised rate not calculated due to incomplete data) and emergency visits in 45.8% vs 43.4% (annualised rate: 0.42 [1.18] vs 0.29 [0.69], P<0.001) of patients with vs without inflammation. Outpatient visits occurred in 91.7% of both groups, with higher annualised rates for patients with inflammation (21.79 [19.86] vs 19.02 [14.54], P<0.001). Diagnostic cardiac CT, and antihypertensive, antidiabetic, antiplatelet, and anticoagulant therapies were used more frequently in patients with inflammation (P<0.001). Mean annualised total direct medical costs (NIS) were higher with inflammation (82,901 [120,556] vs 61,351[93,288]), driven by hospitalisations (90,615 [123,310] vs 69,843 [97,488]; P<0.001).
CONCLUSIONS: Israeli patients with ASCVD and CKD with inflammation had higher HCRU and costs than those without, highlighting the need to identify these high-risk patients and explore tailored therapeutic pathways.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE309
Topic
Economic Evaluation, Health Policy & Regulatory, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), Urinary/Kidney Disorders