Abstract 12315: Healthcare Resource Utilization and Costs Associated With New York Heart Association Functional Class in Patients With Obstructive Hypertrophic Cardiomyopathy in the United States

Abstract

Background: In obstructive hypertrophic cardiomyopathy (HCM), New York Heart Association (NYHA) class has been associated with increased risks of adverse cardiovascular (CV) outcomes that may require more intensive healthcare. Research Question: Is NYHA class associated with healthcare resource utilization (HCRU) and costs in obstructive HCM? Aims: To describe all-cause and CV-related HCRU and costs by NYHA class in obstructive HCM. Methods: This was a retrospective cohort study of adults with obstructive HCM and ≥1 documented NYHA class in Optum’s de-identified Market Clarity database (administrative claims linked with electronic health records [EHR]) from 1/1/2017 to 3/31/2022. Index date was the date of the first NYHA class (i.e., index NYHA class) on or after the earliest date for diagnosis of obstructive HCM or, if any, septal reduction therapy. Annualized all-cause and CV-related HCRU and costs, overall and stratified by the index NYHA class, were assessed using claims during the 182 days after index (i.e., follow-up). Costs were adjusted to 2022 USD. Results: A total of 754 patients were included, with 20.0%, 44.0%, 30.2%, and 5.7% having NYHA class I, II, III, and IV at index, respectively ( Table ). The annual number of all-cause hospitalizations increased with higher index NYHA classes (mean ± SD 0.3 ± 1.0, 1.0 ± 1.8, 1.6 ± 2.6, and 2.1 ± 2.8 for class I, II, III, and IV, respectively). A similar trend was observed for emergency room visits, outpatient visits, and other visits. The total all-cause costs were higher for patients with worse index NYHA classes (mean ± SD $35,339 ± 64,594, $62,899 ± 86,765, $77,727 ± 109,519, and $123,058 ± 139,867 for class I, II, III, and IV, respectively). CV-related HCRU and costs were also generally higher for patients with a worse index NYHA class. Conclusion(s): Obstructive HCM was associated with a substantial economic burden. A worse NYHA class was associated with higher all-cause and CV-related HCRU and costs in obstructive HCM.