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. 2022 Jun;11(2):249-267.
doi: 10.1007/s40119-022-00257-7. Epub 2022 Mar 1.

Treatment Changes, Healthcare Resource Utilization, and Costs Among Patients with Symptomatic Obstructive Hypertrophic Cardiomyopathy: A Claims Database Study

Anjali T Owens  1 , Megan B Sutton  2 , Wei Gao  3 , Jennifer T Fine  2 , Jipan Xie  4 , Srihari S Naidu  5 , Nihar R Desai  6
Affiliations

Treatment Changes, Healthcare Resource Utilization, and Costs Among Patients with Symptomatic Obstructive Hypertrophic Cardiomyopathy: A Claims Database Study

Anjali T Owens et al. Cardiol Ther. 2022 Jun.

Abstract

Introduction: There is limited evidence on therapies for obstructive hypertrophic cardiomyopathy (HCM), and data regarding treatment patterns and cost are scarce. This study assessed treatment patterns and economic outcomes in patients with symptomatic obstructive HCM.

Methods: Adults with symptomatic obstructive HCM as per study design and treated with pharmacotherapies [beta blockers (BBs), calcium channel blockers (CCBs), BB + CCB, or disopyramide] or procedures (septal reduction therapy, heart transplantation, implantable cardioverter-defibrillator, and pacemaker implantation) were identified from the IBM® MarketScan® Commercial and Medicare Supplemental database (January 2009-March 2019). Patients had 12-month continuous eligibility before and after (study period) treatment initiation (index treatment). Healthcare resource utilization (HRU), costs, and treatment changes were assessed.

Results: Of the 4883 patients included in the analysis, 85% received pharmacotherapies (BB 52.5%; CCB 11.7%; BB + CCB 17.7%; disopyramide 2.4%) and 15.7% underwent procedures. During the study period, 38, 34, and 100% of all patients had ≥ 1 inpatient stay, emergency room (ER) visit, and outpatient visit, respectively; mean total healthcare costs were US$53,053. Patients undergoing procedures had the highest HRU and costs across groups. Among patients receiving pharmacotherapies, HRU was lowest with BBs and highest with disopyramide. Treatment changes were observed in 43.8% of patients receiving pharmacotherapies.

Conclusions: Patients experienced high rates of treatment changes, and the economic burden associated with symptomatic obstructive HCM increased as therapy escalated. More effective therapies are needed to stabilize or decrease the economic burden of obstructive HCM.

Keywords: Healthcare costs; Healthcare resource utilization; Obstructive hypertrophic cardiomyopathy; Treatment change.

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Figures

Fig. 1
Fig. 1
Definition of index date (a) and treatment changes (b). HCM Hypertrophic cardiomyopathy
Fig. 2
Fig. 2
Sample selection. aIndex date is the initiation date of a pharmacotherapy or date of procedure for HCM. SRT Septal reduction therapy
Fig. 3
Fig. 3
Frequency of symptoms, conditions, and procedures in treated patients with symptomatic obstructive hypertrophic cardiomyopathy at any time before the start of the study
Fig. 4
Fig. 4
Distribution of index treatment among treated patients with symptomatic obstructive hypertrophic cardiomyopathy. a “Other” included heart transplantation and pacemaker implantation. BB Beta blocker, CCB calcium channel blocker, ICD implantable cardioverter-defibrillator
Fig. 5
Fig. 5
All-cause healthcare costs during the study period. ER Emergency room, IP inpatient, OP outpatient
Fig. 6
Fig. 6
Kaplan–Meier analysis of time to the first HCM-related healthcare resource utilization among patients with symptomatic obstructive HCM who received a pharmacotherapy as the index treatment. aOne patient underwent SRT on the index date
Fig. 7
Fig. 7
Kaplan–Meier analysis of time to treatment changes among patients with symptomatic obstructive hypertrophic cardiomyopathy who received a pharmacotherapy as the index treatment. CI confidence interval
See this image and copyright information in PMC

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