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

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 IBMÒ MarketScanÒ 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 C 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

Clinical Characteristics and Healthcare Resource Utilization among Patients with Obstructive Hypertrophic Cardiomyopathy Treated in a Range of Settings in the United States

“…Contrary to previous investigations, comorbidities in this cohort were remarkably higher than previously reported at HCM centers [2,4,6,7,9]. However, rates of comorbidities, drug therapy, and HCM-related outcomes were similar in comparison to recent investigations using IBM MarketScan Commercial and Medicare claims data [24,25]; however, our study utilized IBM EMR data. Regardless, these studies [24,25], like our results, highlight the differences in real-world HCRU and outcomes among patients with oHCM compared with HCM centers.…”

“…However, rates of comorbidities, drug therapy, and HCM-related outcomes were similar in comparison to recent investigations using IBM MarketScan Commercial and Medicare claims data [24,25]; however, our study utilized IBM EMR data. Regardless, these studies [24,25], like our results, highlight the differences in real-world HCRU and outcomes among patients with oHCM compared with HCM centers. This may reflect differences in disease management between community-based practice and specialized HCM centers of excellence; however, the high rates of comorbidities may also be partly due to a lack of specific and appropriate use of ICD codes.…”

Resource utilization and costs related to the management of obstructive hypertrophic cardiomyopathy under the Brazilian supplementary healthcare system´s perspective: results from a modified Delphi panel

“…The main cost drivers analysis by Jain et al (2021) highlights hospitalization, while procedures represent most of the estimated value in the present study (Jain et al, 2021). Similarly, Owens et al (2022) reported that patients undergoing procedures demand greater resource utilization and costs (Owens et al, 2022). In our analysis, costs related to emergency visits and hospitalization increase among NYHA III and IV patients, especially hospitalizations in the later group.…”

“…The questionnaires were emailed, and the specialists were given two weeks to respond. economic impact of the disease (Jain et al, 2021;Hurst et al, 2022;Owens et al, 2022;Butzner et al, 2022c;Yandrapalli et al, 2022;Javidgonbadi et al, 2021). Unfortunately, there is a lack of Brazilian data regarding this matter.…”

Características Clínicas, Diagnósticas E De Tratamento Da Cardiomiopatia Hipertrófica Em Adultos: Uma Revisão De Literatura

“…Os padrões de herança mais comuns são herança autossômica dominante e mutações "de novo" em casos sem relação familiar (BISWAS; RAZA; DAS; KAPOOR et al, 2019;GUO;WANG;GU et al, 2020;HEDBERG-OLDFORS;ABRAMSSON;OSBORN;DANIELSSON et al, 2019;MARIAN;TAN;LI;CHANG et al, frêmito sistólico e impulso apical aumentado, além de pulso arterial "bisferiens" e onda "a" aumentada no pulso venoso (FARAHANI; ARUNACHALAM; SUNDARAM; PASUPATHY et al, 2020;ZHANG;GU et al, 2020). O uso de medicações somente está indicado a partir do início dos sintomas, sendo a primeira linha de tratamento os betabloqueadores (BUTZNER; ROWIN; YAKUBU; SEALE et al, 2022;MONDA;LIONCINO;PALMIERO;FRANCO et al, 2022;OWENS;SUTTON;GAO;FINE et al, 2022). Não há grandes estudos que comprovem diferença entre os fármacos dessa classe, mas algumas evidências sugerem que propranolol e fármacos antiarrítmicos de classe III como o sotalol podem ter maiores benefícios em pacientes com CMH (BUTZNER; ROWIN; YAKUBU; SEALE et al, 2022).…”