Economic Burden of Chronic Hypoparathyroidism in US Clinical Practice

Presentation Number: MON 346
Date of Presentation: April 3rd, 2017

Kristina Chen*1, Sarah Qin2, Derek Weycker2, Hongsheng Wu2, Montserrat Vera-Llonch1, Alan Krasner1, Lauren Remkus1 and Gerry Oster2
1Shire Human Genetic Therapies, Inc., Lexington, MA, 2Policy Analysis Inc. (PAI), Brookline, MA

Abstract

Background

Chronic hypoparathyroidism (HypoPT) is a rare disorder characterized by absent/deficient levels of parathyroid hormone and impaired mineral homeostasis. While the etiology and short-term clinical consequences of chronic HypoPT are fairly well documented, relatively little is known about the economic burden of this disorder in real-world settings.

Methods

A retrospective cohort study was undertaken using data from a large US healthcare claims repository spanning the period January 2010 to June 2015. Study population included adult patients (aged ≥18 years) with evidence of chronic HypoPT, which was defined by one of the following criteria: (1) ≥2 hospitalizations or ambulatory visits with ICD-9-CM diagnosis codes for HypoPT (ICD‑9‑CM 252.1) separated by at least 180 days; or (2) any encounters for HypoPT coupled with any encounters for hypocalcemia (275.41), hypercalcemia (275.42), hypercalciuria (275.40), or hyperphosphatemia (275.3) separated by at least 180 days. Analyses characterized the demographic and clinical profile of the study population as well as their annualized levels of resource utilization and associated costs (2015 US$), for specific services and medications that may be related to HypoPT and for all causes, respectively.

Results

A total of 5799 subjects met study-selection criteria; mean (SD) age was 54 (15) years and 78% were women. Common comorbidities included chronic kidney disease (12%), ischemic heart disease (8%), cardiac arrhythmia (8%), and renal insufficiency (6%); prevalence of conditions deemed possibly related to HypoPT included 13% for dyspnea/respiratory abnormality and 6% for numbness/tingling. Patients with HypoPT averaged—on an annual basis—0.3 (95% CI: 0.28-0.32) hospitalizations, 1.7 (1.5-1.9) hospital days, and 31.1 (30.2-32.0) ambulatory encounters for any reason. Mean annual all-cause healthcare expenditures totaled $26,889 ($25,017-$28,761); ambulatory encounters accounted for 60% of this total ($16,028 [$14,645-$17,411]), while hospitalizations accounted for 27% of the total ($7,373 [$6417-$8329]). Hospitalizations and ambulatory encounters for disorders of the kidney and cardiovascular system, respectively, as well as conditions possibly related to HypoPT, were common.

Conclusions

Levels of healthcare utilization and costs are high in patients with HypoPT; ambulatory care accounts for more than one-half of the total economic burden of the disease in US clinical settings.

 

Disclosure: KC: Employee, Shire. SQ: Consultant, Shire. DW: Consultant, Shire. HW: Consultant, Shire. MV: Employee, Shire. AK: Employee, Shire. LR: Employee, Shire. GO: Consultant, Shire.