Pradigastat Did Not Increase Fecal Bile Acids in Patients with Familial Chylomicronemia Syndrome After 52 Weeks

Abstract

Lead Author’s Financial Disclosures: Dr. Becker has received a grant from Amgen Inc. Study Funding: This study was funded by Amgen Inc. Background/Synopsis: While many studies have examined cost of MI or stroke, few have compared the cost of initial and recurrent events. This study provides information about how treatment intensity may change based on event type and provides more accurate costs for economic models. In the elderly Medicare population, a recurrent stroke costs more than initial stroke; however, the cost of a recurrent myocardial infarction (MI) is lower than the initial MI. Objective/Purpose: This analysis will describe health expenditures following initial and recurrent MI or stroke among elderly Medicare beneficiaries. Methods: We used Medicare claims data to identify beneficiaries who were hospitalized between Jan. 1, 2006 and Dec. 31, 2011 with MI or stroke. For each patient, we identified the first MI or stroke hospitalization meeting our case-definition, which requires a primary diagnosis (or procedure codes) of MI or stroke and no hospitalizations for any cardiovascular events during the prior 18 months. We also limited our analysis to beneficiaries who were $65 and who were continuously enrolled in fee-for-service Medicare during the 18 months prior to their index hospitalization and the 90 days following their index event. We identified mean unadjusted inpatient and outpatient medical expenditures in the 90-day period following index and recurrent MI and stroke hospitalizations. Outpatient drug expenditures were not captured. To identify recurrent MI or stroke hospitalizations, we require a minimum of 30 days between the index discharge date and the admission date for a hospitalization with the same diagnosis. Events occurring within 30 days were assumed to be part of the initial event. Results: As shown in the table below, average expenditures in the 90-day period following index MI and stroke hospitalizations are similar. In contrast, the average expenditures of recurrent hospitalizations are higher than initial hospitalizations for stroke but are lower for MI. Conclusions: Whereas the mean expenditures for index MI and stroke hospitalizations are similar, the average costs of recurrent hospitalizations are higher for stroke patients. These patterns may be explained by increased treatment intensity during index MI hospitalizations relative to recurrent hospitalizations and increased treatment intensity in the recurrent events for stroke patients. These estimates can be used to more accurately assess cost-effectiveness of interventions that reduce cardiovascular events in an elderly Medicare population.