Abstract 11720: Logistic and Economic Burden of Non-Obstructive Hypertrophic Cardiomyopathy - Results From Medical and Pharmacy Claims Data

Abstract

Introduction: Data are limited on the complication burden of non-obstructive hypertrophic cardiomyopathy (nHCM). Hypothesis: Symptoms and complications increase the logistic and economic burden of nHCM. Aim: To assess pre vs post complication resource use and charges (per person per year [PPPY], in USD) for patients with nHCM. Methods: We used Symphony medical and pharmacy claims data from 2016-2021 to identify (by ICD-10 code) 18,011 adult patients in the United States with symptomatic (SYMP) or asymptomatic (ASYMP) nHCM. SYMP was defined as fatigue, chest pain, syncope, dyspnea, heart failure (HF), or palpitations within 3 months of index date; and complications as atrial fibrillation (AF)/flutter, ventricular fibrillation/tachycardia (VF/VT), supraventricular tachycardia, stress cardiomyopathy, HF, or heart transplant. Results: In SYMP vs ASYMP nHCM (n=9600 vs 8411), mean age was 63±14 vs 62±16 years ( p <0.001), 49% vs 45% were female ( p <0.001), and incidence of complications was 0.96 vs 0.39 per 1000 patient years ( p <0.001; HR 0.44, 95% CI 0.40-0.48). For both groups, the most frequent complications were HF, AF and VT. In SYMP nHCM, complications increased inpatient (IP) admissions ( p <0.001 ) and all-cause charges ($59,070 to $73,630 PPPY; p =0.006), without altering outpatient (OP) visits ( p =0.438) (Fig.). In ASYMP nHCM, complications increased IP admissions, OP visits (both p <0.001), and all-cause charges ($22,711 to $66,053 PPPY; p <0.001) (Fig.). For patients with SYMP vs ASYMP nHCM, incremental post complication charges were $14,560 vs $43,343 PPPY, p =0.007. Conclusions: In this study, patients with SYMP vs ASYMP nHCM were older, predominantly female, and had higher rates of complications. Irrespective of symptoms, complications were associated with increased IP admissions and charges. Our data highlight the value of complication prevention, especially for patients with ASYMP nHCM, for whom complications may steeply increase charges.