Health Care Resource Utilization in Transthyretin Amyloid Cardiomyopathy Compared With Non-amyloid Heart Failure and the General Population.

BACKGROUND

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, fatal disease associated with a substantial health care system burden. The aim of this study was to compare health care resource utilization and associated costs among individuals with ATTR-CM, with non-amyloid heart failure (HF), and without HF in the United States.

METHODS

Optum's de-identified Clinformatics Data Mart Database (January 2016 to September 2023) was used to identify patients with ATTR-CM based on HF and/or cardiomyopathy claims within 2 years of the first ATTR diagnosis. Patients with ATTR-CM were matched to patients with non-amyloid HF (HF/cardiomyopathy without ATTR) and non-HF controls using 1:1 propensity score matching. All-cause and cardiovascular-related hospitalizations and costs were compared during follow-up.

RESULTS

Each matched cohort included 4571 patients (mean age, 75.3-75.5 years; 56.0%-56.6% male; mean follow-up: 2.9-3.2 years). The ATTR-CM, non-amyloid HF, and non-HF cohorts had 3.3, 2.7, and 1.5 all-cause hospitalizations per patient during follow-up, respectively. Compared with non-amyloid HF, patients with ATTR-CM had a longer mean length of stay per hospitalization (all-cause and cardiovascular-related: 8.0 versus 7.5 days; P<0.001), more mean days hospitalized annually per patient (all-cause: 10.6 versus 8.4; cardiovascular-related: 10.5 versus 8.3 [both P<0.001]), and higher mean annual inpatient hospitalization costs per patient (all-cause: $42 868 versus $36 061; cardiovascular-related: $42 841 versus $36 027 [both P<0.001]). In ATTR-CM subgroups, mean cardiovascular-related length of stay and days hospitalized were higher among patients aged 46 to 64 years and 65 to 80 years (versus >80 years), Black patients (versus White patients), and patients in the Northeast or South US regions (versus West regions).

CONCLUSIONS

ATTR-CM is associated with a higher health care resource utilization/cost burden than non-amyloid HF and the general population.