OBJECTIVES : Characterize variations in downstream healthcare costs and catheter ablations in patients age <18y, 18-40y, and 41-64y newly diagnosed with Paroxysmal Supraventricular Tachycardia (PSVT).

METHODS : Commercially insured patients from the Truven Health MarketScan^® database with newly diagnosed PSVT (ICD-9: 427.0; ICD-10: I47.1) from January 1, 2011 to December 31, 2014 were included when observable three years before and after index diagnosis. Propensity matched controls were identified. Outcome measures included mean annual per-patient costs paid by insurers 3 years pre- and post-diagnosis, as well as ablations within 1 year post-diagnosis.

RESULTS : The majority of the 13,092 newly diagnosed patients were age 41-64y (Age <18y: N=780; 6.0%; 18-40y: N=2,324; 17.8%; 41-64y: N=9,988; 72.3%) and female sex (Age <18y: 50.6% vs. 18-40y: 68.0%; vs. 41-64y: 62.5%). Costs in all age groups were relatively stable in the 13-36 months before index but rose significantly in the year immediately preceding diagnosis (P<0.0001). In the year immediately following diagnosis, costs more than tripled in patients age <18y (from $46,739 to $23,904; P<0.0001), and doubled in patients age 18-40y (from $10,203 to $20,127; P<0.0001) and 41-64y (from $11,796 to 23,543; P<0.0001) relative to the pre-diagnosis year. Costs for healthcare encounters with PSVT diagnoses accounted for more than two-thirds of these cost increases (Age <18y: 78.2%; 18-40y: 82.9%; age 41-64y: 68.2%). The proportion of patients treated with ablation in the year following PSVT diagnosis was highest in younger patients and decreased with age (Age <18y: 30.4% vs. 18-40y: 16.4% vs. 41-64y: 12.2%; P<0.0001). Matched control patients in all age groups had significantly lower costs throughout the study period (P<0.0001).

CONCLUSIONS : Healthcare costs increased in the year immediately preceding PSVT diagnosis across all ages, consistent with the challenges in making a PSVT diagnosis. Cost increases following diagnosis may reflect costs of monitoring, ablation procedures, and medical management for PSVT.