Abstract P238: The Economic Burden of Hypertriglyceridemia

Abstract

One-third of US adults has elevated triglyceride levels, but the medical care costs associated with this common lipid abnormality have not been described. Using an observational cohort design, we analyzed the comprehensive electronic medical records of all 108,324 individuals aged 18 or older who had triglyceride (TG) measurements in 2008 and were members of Kaiser Permanente Northwest for the entire year. After assigning patients to TG categories of < 150, 150-199, 200-499, and ≥500 mg/dl, we calculated and compared annual direct medical costs. To isolate the independent contribution of TGs, we adjusted costs for age, sex, body mass index, blood pressure, smoking history, other lipid fractions, and health conditions such as cardiovascular disease, diabetes, and renal disease. Of the 108,324 study subjects, 64.1% had normal TG levels (<150mg/dl), 16.4% had borderline high levels (150-199mg/dl), 18.0% had high TG levels (200-499mg/dl) and 1.5% had very high TG levels of ≥ 500mg/dl. Unadjusted costs followed a stepped association with TG levels. After adjustment, patients with TG levels ≥ 500mg/dl had significantly higher mean total costs ($8,567; 99% CI $7,034-10,100) than those with levels of < 150mg/dl ($6,186; $6,058-6,314), 150-199mg/dl ($6,449; $6,196-6,702), or 200-499mg/dl ($6,376; $6,118-6,634). The differences were driven by both outpatient and pharmaceutical costs. Inpatient costs were also higher among those with TG levels ≥ 500mg/dl but did not reach statistical significance. Severe hypertriglyceridemia is associated with higher medical costs on the order $2,100 to $2,400 per annum (33-38%) independent of resource-intensive comorbid conditions.