PCV34 MEDICATION USE, HEALTH CARE RESOURCE USE AND DIRECT MEDICAL COSTS FOR PATIENTS WITH VERY-HIGH-RISK ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN CHINA

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To investigate medication use, health care resource use and direct medical costs for patients with very-high-risk atherosclerotic cardiovascular disease (ASCVD) in China. Data were obtained from Urban Employee Basic Medical Insurance database (2013-2017) in Tianjin, China. Very-high-risk ASCVD patients with medical history of 1 major ASCVD event combined with multiple high-risk conditions or history of multiple major ASCVD events were identified between 2014 and 2015, and followed for 24 months. Medication use including statins, antiplatelets, β-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists (ACEIs/ARBs) was investigated with each 3-month as an interval. All-cause health care resource utilization including hospitalizations and outpatient visits were estimated respectively, and all-cause direct medical costs were also calculated. 34,740 patients with very-high-risk ASCVD were included (mean age: 67.1 years; 42.5% female), which accounted for 35.2% of clinical ASCVD patients. The medication use was suboptimal among included patients. The prescription percentages for antiplatelets, statins, ACEIs/ARBs, β-blockers in the first 3-month follow-up were 69.7%, 58.7%, 49.9% and 29.3% respectively, which gradually decreased in the following follow-up. In the first 12-month follow-up, 57.5% of patients experienced ≥1 hospitalization, with a mean (SD) length of stay of 13.1 (7.9) days and a mean cost of ¥17306.2 per admission. 99.1% of patients experienced ≥1 outpatient visit with a mean (SD) number of visits of 44.4 (39.2) and a mean cost of ¥277.8 per visit. The annual mean all-cause costs were ¥20564.5 per patient, in which medication cost accounted for 58.0%. Use of cardiovascular medications in very-high-risk ASCVD patients was poor in China, and their medical burden were considerable driven by the hospitalization cost. Efforts aiming to improve drug adherence among very-high-risk ASCVD patients may have the potential to reduce the use of inpatient services and lead to better economic outcomes.