Determining initial and follow-up costs of cardiovascular events in a US managed care population

Richard H. Chapman, Larry Z. Liu, Prafulla G. Girase, Robert J. Straka

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23 Scopus citations

Abstract

Background: Cardiovascular (CV) events are prevalent and expensive worldwide both in terms of direct medical costs at the time of the event and follow-up healthcare after the event. This study aims to determine initial and follow-up costs for cardiovascular (CV) events in US managed care enrollees and to compare to healthcare costs for matched patients without CV events.Methods: A 5.5-year retrospective matched cohort analysis of claims records for adult enrollees in ~90 US health plans. Patients hospitalized for first CV event were identified from a database containing a representative sample of the commercially-insured US population. The CV-event group (n = 29,688) was matched to a control group with similar demographics but no claims for CV-related events. Endpoints were total direct medical costs for inpatient and outpatient services and pharmacy (paid insurance amount).Results: Overall, mean initial inpatient costs were US dollars ($) 16,981 per case (standard deviation [SD] = $20,474), ranging from $6,699 for a transient ischemic attack (mean length of stay [LOS] = 3.7 days) to $56,024 for a coronary artery bypass graft (CABG) (mean LOS = 9.2 days). Overall mean health-care cost during 1-year follow-up was $16,582 (SD = $34,425), an excess of $13,792 over the mean cost of matched controls. This difference in average costs between CV-event and matched-control subjects was $20,862 and $26,014 after two and three years of follow-up. Mean overall inpatient costs for second events were similar to those for first events ($17,705/case; SD = $22,703). The multivariable regression model adjusting for demographic and clinical characteristics indicated that the presence of a CV event was positively associated with total follow-up costs (P < 0.0001).Conclusions: Initial hospitalization and follow-up costs vary widely by type of CV event. The 1-year follow-up costs for CV events were almost as high as the initial hospitalization costs, but much higher for 2- and 3-year follow-up.

Original languageEnglish (US)
Article number11
JournalBMC Cardiovascular Disorders
Volume11
DOIs
StatePublished - Mar 16 2011

Bibliographical note

Funding Information:
This study was sponsored by Pfizer Inc. The topic of the study was agreed upon with Pfizer Inc at the outset of the project; however, the authors retained full rights in the design, analysis, interpretation, and publication of the results. RJS was a paid consultant to Pfizer Inc in connection with the development of this manuscript. PSG and RHC are employees of IMS Health, who were paid consultants to Pfizer Inc in the development of this manuscript. LZL is an employee of Pfizer Inc with ownership of stock in Pfizer Inc. Editorial support was provided by Dr John Bilbruck at UBC Scientific Solutions Ltd and Karen Trochlil and Katharine Coyle at IMS Health and was funded by Pfizer Inc.

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