PHS36 - Outcomes, Health Care Resources Use, And Costs In Patients With Post-Myocardial Infarction: The Horus Cohort Study In The Egb French Claims And Hospital Database

Abstract

To estimate real-life outcomes, healthcare resources use and costs in patients with post-myocardial infarction (MI), and in a subpopulation similar to the PEGASUS-TIMI 54 trial (PEG), performed to assess long-term use of ticagrelor in patients with prior MI. Cohort study in the EGB, a 1/97 representative sample of the French nationwide claims and hospital database. Post-MI patients had MI between 2005 and 2010 and 1-year event-free period after MI (index date). PEG patients were those with at least one of these risk factors: ≥ 50 years, diabetes, history of MI, or renal disease, but without history of stroke, dialysis, and current use of oral anticoagulant. Patients were followed for 3 years after index date with censure in December 2012. The primary outcome was a composite of death, hospitalization for MI or stroke. Healthcare resources use and their costs were estimated from the societal perspective. 1764 post-MI and 951 PEG patients were identified, representing 4348 and 2314 person-years (PY), with 68% and 61% of men, and a mean age of 66 and 74 years, respectively. Patients were mainly followed by GPs with a high rate of use of cardiovascular secondary prevention drugs. Primary outcome incidence rate [95%CI] was 6.5 [5.7;7.2], and 7.9 [6.8;9.0] per 100 PY, respectively, and deaths represented about 80% of this composite outcome. The mean healthcare cost per patient followed for three years was about 20,000€ for the post-MI population, 21% were for non-cardiovascular hospitalizations, 16% for cardiovascular plus antidiabetic drugs, and 13% for cardiovascular hospitalizations. The cost structure was similar for the PEG population. For patients who survived one year after a MI, death represented the main event of the composite criterion. The cost of cardiovascular hospitalizations and cardiovascular plus antidiabetic drugs represented about a quarter of the mean healthcare cost per patient.