HEALTHCARE RESOURCE UTILISATION FOR 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, Benjamin Bray, PhD, MD3, Alistair Marsland, MPhys3, 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 cardiovascular condition associated with high morbidity and mortality. This study aimed to characterise healthcare resource utilisation (HCRU) before and after diagnosis of ATTR‑CM in Japan.
METHODS: This retrospective open-cohort study used the Medical Data Vision database, a Japanese claims and electronic health-record dataset, to characterise HCRU among adults with ATTR-CM. 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. Individuals with <6 months of pre-index data, light-chain amyloidosis or multiple myeloma were excluded. The index date was the first encounter when all inclusion criteria were met. Serial cross-sections were constructed to estimate HCRU (inpatient, outpatient, laboratory/imaging, emergency department, and homecare visits) number of unique medical prescriptions, and median length of hospital stay (LOS).
RESULTS: Total HCRU (excluding prescriptions) rose from 10.6 to 25.5 events per-person-per-year (PPPY) before diagnosis and peaked at 50.8 events PPPY in the first 6 months after diagnosis, driven by increased inpatient, laboratory, and outpatient use. Although utilisation declined thereafter, it remained above pre-index levels. Prescriptions also escalated, increasing from 4.6 to 15.8 unique prescriptions PPPY pre-index, before peaking at 30.6 PPPY in the first 6 months post-diagnosis; rates dropped thereafter but remained above pre-index levels. Median LOS increased from 13.0 days (interquartile range: 3.0-18.5) at 2-3 years pre-index to 21.0 days (5.0-26.0) 0-6 months before index. Median LOS then declined from 18.0 days (4.0-25.0) at 0-6 months post-index to 16.0 days (4.0-23.0) at 2-3 years post-index.
CONCLUSIONS: HCRU increased substantially in the approach to and immediately after the diagnosis of ATTR-CM, indicating a period of marked clinical complexity. Although all markers of utilisation declined after diagnosis, levels remained consistently above early pre‑index periods, demonstrating a sustained post‑diagnosis healthcare burden.
METHODS: This retrospective open-cohort study used the Medical Data Vision database, a Japanese claims and electronic health-record dataset, to characterise HCRU among adults with ATTR-CM. 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. Individuals with <6 months of pre-index data, light-chain amyloidosis or multiple myeloma were excluded. The index date was the first encounter when all inclusion criteria were met. Serial cross-sections were constructed to estimate HCRU (inpatient, outpatient, laboratory/imaging, emergency department, and homecare visits) number of unique medical prescriptions, and median length of hospital stay (LOS).
RESULTS: Total HCRU (excluding prescriptions) rose from 10.6 to 25.5 events per-person-per-year (PPPY) before diagnosis and peaked at 50.8 events PPPY in the first 6 months after diagnosis, driven by increased inpatient, laboratory, and outpatient use. Although utilisation declined thereafter, it remained above pre-index levels. Prescriptions also escalated, increasing from 4.6 to 15.8 unique prescriptions PPPY pre-index, before peaking at 30.6 PPPY in the first 6 months post-diagnosis; rates dropped thereafter but remained above pre-index levels. Median LOS increased from 13.0 days (interquartile range: 3.0-18.5) at 2-3 years pre-index to 21.0 days (5.0-26.0) 0-6 months before index. Median LOS then declined from 18.0 days (4.0-25.0) at 0-6 months post-index to 16.0 days (4.0-23.0) at 2-3 years post-index.
CONCLUSIONS: HCRU increased substantially in the approach to and immediately after the diagnosis of ATTR-CM, indicating a period of marked clinical complexity. Although all markers of utilisation declined after diagnosis, levels remained consistently above early pre‑index periods, demonstrating a sustained post‑diagnosis healthcare burden.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE625
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas, Rare & Orphan Diseases