FACTORS ASSOCIATED WITH INCREASED HEALTHCARE RESOURCE UTILISATION IN INDIVIDUALS WITH TRANSTHYRETIN AMYLOID CARDIOMYOPATHY: RESULTS FROM A JAPANESE ELECTRONIC HEALTH RECORD DATABASE
Author(s)
Silvia Capucci, MSc1, René Lindholm Cordtz, PhD, MD1, Masaya Otsu, PhD2, Alistair Marsland, MPhys3, Steven Bright, MSc3, Andrew Thompson, PhD3, Hideo Yasunaga4.
1Novo Nordisk A/S, Søborg, Denmark, 2Novo Nordisk Pharma Ltd, Tokyo, Japan, 3LCP Health, Lane, Clark and Peacock LLP, London, United Kingdom, 4University of Tokyo, Tokyo, Japan.
1Novo Nordisk A/S, Søborg, Denmark, 2Novo Nordisk Pharma Ltd, Tokyo, Japan, 3LCP Health, Lane, Clark and Peacock LLP, London, United Kingdom, 4University of Tokyo, Tokyo, Japan.
OBJECTIVES: Transthyretin amyloid cardiomyopathy (ATTR‑CM) is an under-recognised condition with high morbidity and mortality. This study explored factors associated with high healthcare resource utilisation (HCRU) in patients diagnosed with ATTR‑CM in Japan.
METHODS: This retrospective open‑cohort study used the Medical Data Vision database, a Japanese claims and electronic health‑record dataset. The study period spanned 1 January 2008 to 30 June 2024. ATTR‑CM was identified using predefined amyloidosis diagnosis codes or tafamidis prescriptions plus a confirmed diagnosis of heart failure, cardiomyopathy or arrhythmia. The index date was the first encounter when all inclusion criteria were met. Factors associated with HCRU (inpatient, outpatient, laboratory/imaging, emergency department, and homecare visits) were explored using descriptive analysis and negative binomial regression.
RESULTS: The analysis included 17,595 individuals; 39.5% were female, with a mean age of 71 years (SD=15). Renal dysfunction was the clearest and most consistent predictor of high HCRU. Patients with renal failure had more than double the index event rate of those without (92.8 vs 44.2 per person-year; ratio 2.10), with sustained differences through 7-12 months, 1-2 years and 2-3 years post-index. Other high-HCRU subgroups reflected cardiovascular complexity and multimorbidity, including anticoagulant use (58.3 vs 24.6; ratio 2.37), diuretics (60.7 vs 34.1; 1.78), anti-arrhythmics (66.2 vs 46.1; 1.44), liver disease (84.9 vs 49.2; 1.72) and hypoalbuminaemia (79.7 vs 50.3; 1.58). In the adjusted negative binomial model, renal failure remained the dominant predictor, associated with an 88% higher encounter rate (incidence rate ratio [IRR]) 1.88, 95% confidence interval 1.81-1.96). Oral anticoagulation was next strongest (IRR 1.70, 1.65-1.76), while NYHA III/IV predicted 21-23% higher HCRU.
CONCLUSIONS: High HCRU in patients with ATTR-CM was associated primarily with renal failure, with additional burden associated with anticoagulation, advanced heart failure and other comorbidities. These results highlight opportunities to target monitoring, treatment and service planning towards patients at greatest risk of intensive HCRU.
METHODS: This retrospective open‑cohort study used the Medical Data Vision database, a Japanese claims and electronic health‑record dataset. The study period spanned 1 January 2008 to 30 June 2024. ATTR‑CM was identified using predefined amyloidosis diagnosis codes or tafamidis prescriptions plus a confirmed diagnosis of heart failure, cardiomyopathy or arrhythmia. The index date was the first encounter when all inclusion criteria were met. Factors associated with HCRU (inpatient, outpatient, laboratory/imaging, emergency department, and homecare visits) were explored using descriptive analysis and negative binomial regression.
RESULTS: The analysis included 17,595 individuals; 39.5% were female, with a mean age of 71 years (SD=15). Renal dysfunction was the clearest and most consistent predictor of high HCRU. Patients with renal failure had more than double the index event rate of those without (92.8 vs 44.2 per person-year; ratio 2.10), with sustained differences through 7-12 months, 1-2 years and 2-3 years post-index. Other high-HCRU subgroups reflected cardiovascular complexity and multimorbidity, including anticoagulant use (58.3 vs 24.6; ratio 2.37), diuretics (60.7 vs 34.1; 1.78), anti-arrhythmics (66.2 vs 46.1; 1.44), liver disease (84.9 vs 49.2; 1.72) and hypoalbuminaemia (79.7 vs 50.3; 1.58). In the adjusted negative binomial model, renal failure remained the dominant predictor, associated with an 88% higher encounter rate (incidence rate ratio [IRR]) 1.88, 95% confidence interval 1.81-1.96). Oral anticoagulation was next strongest (IRR 1.70, 1.65-1.76), while NYHA III/IV predicted 21-23% higher HCRU.
CONCLUSIONS: High HCRU in patients with ATTR-CM was associated primarily with renal failure, with additional burden associated with anticoagulation, advanced heart failure and other comorbidities. These results highlight opportunities to target monitoring, treatment and service planning towards patients at greatest risk of intensive HCRU.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE471
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Rare & Orphan Diseases