Quantifying the real-world clinical and economic burden of chronic hypoparathyroidism on secondary care in England: A multi-arm, retrospective cohort study

Gittoes, Neil; Iqbal, Kamran; Marelli, Claudio; Vintderdag, Helene; Zouraq, Ismail Azzabi; Were, Jay; Dass, Nin

doi:10.1530/endoabs.73.aep93

Cited by 3 publications

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“…In England, HCRU was significantly higher among patients with chronic HypoPT than patients with hypothyroidism, and those who underwent thyroid surgery but did not have HypoPT. 52 In the USA, annual medical costs for patients with HypoPT have been reported to be 3 times that of age- and sex-matched controls. 53 In the present study, the mean number of doctor/healthcare professional visits decreased from baseline to wk 24 and 52.…”

Section: Discussionmentioning

confidence: 99%

Open-label extension of a randomized trial investigating safety and efficacy of rhPTH(1–84) in hypoparathyroidism

Khan,

Abbott,

Ahmed

et al. 2024

JBMR Plus

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Hypoparathyroidism is a rare disease, often inadequately controlled by conventional treatment. PARALLAX was a mandatory post-marketing trial assessing pharmacokinetics and pharmacodynamics of different dosing regimens of recombinant human parathyroid hormone 1–84 (rhPTH[1–84]) for treating hypoparathyroidism. The present study (NCT03364738) was a Phase 4, 1-year open-label extension of PARALLAX. Patients received only two doses of rhPTH(1–84) in PARALLAX and were thus considered treatment-naive at the start of the current study. rhPTH(1–84) was initiated at 50 μg once daily, with doses adjusted based on albumin-corrected serum calcium levels. Albumin-corrected serum calcium (primary outcome measure), health-related quality of life (HRQoL), adverse events, and healthcare resource utilization (HCRU) were assessed. The mean age of the 22 patients included was 50.0 years; 81.8% were women, and 90.9% were White. By end of treatment (EOT), 95.5% of patients had albumin-corrected serum calcium values in the protocol-defined primary endpoint range of 1.88 mmol/L to the upper limit of normal. Serum phosphorus was within the healthy range, and albumin-corrected serum calcium-phosphorus product was below the upper healthy limit throughout, while mean 24-hour urine calcium excretion decreased from baseline to EOT. Mean supplemental doses of calcium and active vitamin D were reduced from baseline to EOT (2402–855 mg/day and 0.8–0.2 μg/day, respectively). Mean serum bone turnover markers, bone-specific alkaline phosphatase, osteocalcin, procollagen type I N-terminal propeptide, and type I collagen C-telopeptide increased 2–5 fold from baseline to EOT. HCRU, disease-related symptoms and impact on HRQoL improved numerically between baseline and EOT. Nine patients (40.9%) experienced treatment-related adverse events; no deaths were reported. Treatment with rhPTH(1–84) once daily for 1 year improved HRQoL, maintained eucalcemia in 95% of patients, normalized serum phosphorus, and decreased urine calcium excretion. The effects observed on urine calcium and the safety profile are consistent with previous findings.

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Section: Discussionmentioning

confidence: 99%

Open-label extension of a randomized trial investigating safety and efficacy of rhPTH(1–84) in hypoparathyroidism

Khan,

Abbott,

Ahmed

et al. 2024

JBMR Plus

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“…However, a study by Gittoes et al using the HES database reported higher comorbidities, including renal complications and infections, among patients with post-surgical and nonsurgical chronic HypoPT than comparison groups (patients who underwent thyroid surgery and patients with hypothyroidism) [ 10 ]. In line with this UK-based study [ 10 ], a retrospective analysis of US claims data by Deering et al from 2014 to 2019 demonstrated that patients with chronic HypoPT had a higher number of inpatient hospitalizations, more ED visits, and a higher incidence of cardiac and renal complications than patients with transient post-surgical HypoPT [ 22 , 23 ]. Understanding the reasons for the higher prevalence of HypoPT-related inpatient hospitalizations among patients with chronic HypoPT warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Chen et al based on US healthcare claims for hospitalizations and ambulatory visits between 2010 and 2015 found that mean healthcare costs for HypoPT totaled $26 889 per year [ 25 ], a similar value to that observed in our own study. The HES database study conducted by Gittoes et al in the UK reported annual inpatient and outpatient costs of more than £30 000 for 2.7% of patients with HypoPT [ 10 ]. However, while the HES database study included costs for both inpatient and outpatient visits, the current study recorded only inpatient stays, which could account for the difference in total costs observed.…”

Section: Discussionmentioning

confidence: 99%

“…The yearly costs of medical care for patients with HypoPT in the United States have been estimated to be about 3 times those of age- and sex-matched controls [ 9 ]. Additionally, in the United Kingdom, a study using the Hospital Episode Statistics (HES) database highlighted the clinical and economic burden of chronic HypoPT on secondary care [ 10 ]. The study reported a significantly higher occurrence of comorbidities such as renal complications and infections among patients with chronic HypoPT (both post- and nonsurgical) than patients with hypothyroidism and those who underwent thyroid surgery but did not have HypoPT [ 10 ].…”

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Recent Trends in Hypoparathyroidism-Related Inpatient and Emergency Department Admissions and Costs in the United States

Kaul

Gosmanova

Castriota

et al. 2023

Journal of the Endocrine Society

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Hypoparathyroidism (HypoPT) is a rare disease associated with high morbidity. Its economic impact is not well understood. This retrospective, cross-sectional study used data from the United States (US)-based National Inpatient Sample and the Nationwide Emergency Department Sample from 2010 to 2018 to quantify overall trends in number, cost, charges, and length of stay (LOS) for inpatient hospitalizations, and number and charges for emergency department (ED) visits for HypoPT-related and for non-HypoPT-related causes. Additionally, the study estimated the marginal effect of HypoPT on total inpatient hospitalization costs and LOS as well as ED visit charges. Over the observed period, a mean of 56.8–66.6 HypoPT-related hospitalizations and 14.6–19.5 HypoPT-related ED visits were recorded per 100 000 visits per year. Over this period, the rate of HypoPT-related inpatient hospitalizations and ED visits increased by 13.5% and 33.6%, respectively. The mean LOS for HypoPT-related hospitalizations was consistently higher than for non-HypoPT-related causes. Total annual HypoPT-related inpatient hospitalization costs increased by 33.6%, and ED visit charges increased by 96.3%. During the same period, the annual costs for non-HypoPT-related hospitalizations and charges for ED visits increased by 5.2% and 80.3%, respectively. In all years, HypoPT-related hospital encounters resulted in higher charges and costs per individual visit than non-HypoPT-related encounters. The marginal effect of HypoPT on inpatient hospitalization costs and LOS, and on ED charges, increased over the period of observation. In conclusion, this study demonstrated that HypoPT was associated with substantial and increasing healthcare utilization in the US between 2010 and 2018.

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Economic burden of patients with post-surgical chronic and transient hypoparathyroidism in the United States examined using insurance claims data

Deering,

Larsen,

Loustau

et al. 2024

Orphanet J Rare Dis

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Background Hypoparathyroidism (HP) is a rare endocrine disease commonly caused by the removal or damage of parathyroid glands during surgery and resulting in transient (tHP) or chronic (cHP) disease. cHP is associated with multiple complications and comorbid conditions; however, the economic burden has not been well characterized. The objective of this study was to evaluate the healthcare resource utilization (HCRU) and costs associated with post-surgical cHP, using tHP as a reference. Methods This analysis of a US claims database included patients with both an insurance claim for HP and thyroid/neck surgery between October 2014 and December 2019. cHP was defined as an HP claim ≥ 6 months following surgery and tHP was defined as only one HP claim < 6 months following surgery. The cHP index date was the first HP diagnosis claim following their qualifying surgery claim, whereas the tHP index date was the last HP diagnosis claim following the qualifying surgery claim. Patients were continuously enrolled at least 1 year pre- and post-index. Patients’ demographic and clinical characteristics, all-cause HCRU, and costs were descriptively analyzed. Total all-cause costs were calculated as the sum of payments for hospitalizations, emergency department, office/clinic visits, and pharmacy. Results A total of 1,406 cHP and 773 tHP patients met inclusion criteria. The average age (52.1 years cHP, 53.5 years tHP) and representation of females (83.2% cHP, 81.2% tHP) were similar for both groups. Neck dissection surgery was more prevalent in cHP patients (23.6%) than tHP patients (5.3%). During the 1–2 year follow-up period, cHP patients had a higher prevalence of inpatient admissions (17.4%), and emergency visits (26.0%) than the reference group -tHP patients (14.4% and 21.4% respectively). Among those with a hospitalization, the average number of hospitalizations was 1.5-fold higher for cHP patients. cHP patients also saw more specialists, including endocrinologists (28.7% cHP, 15.8% tHP), cardiologists (16.7% cHP, 9.7% tHP), and nephrologists (4.6% cHP, 3.3% tHP). Conclusion This study demonstrates the increased healthcare burden of cHP on the healthcare system in contrast to patients with tHP. Effective treatment options are needed to minimize the additional resources utilized by patients whose HP becomes chronic.

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Quantifying the real-world clinical and economic burden of chronic hypoparathyroidism on secondary care in England: A multi-arm, retrospective cohort study

Cited by 3 publications

References 0 publications

Open-label extension of a randomized trial investigating safety and efficacy of rhPTH(1–84) in hypoparathyroidism

Open-label extension of a randomized trial investigating safety and efficacy of rhPTH(1–84) in hypoparathyroidism

Recent Trends in Hypoparathyroidism-Related Inpatient and Emergency Department Admissions and Costs in the United States

Economic burden of patients with post-surgical chronic and transient hypoparathyroidism in the United States examined using insurance claims data

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