Factors associated with healthcare utilization costs for statin therapy--a pilot study in Hong Kong
C W R Cheng1, J C N Chan, B Tomlinson
1School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, China.
Insights
Male gender, diabetes, congestive heart failure, and coronary atherosclerosis are linked to higher medical costs in Chinese patients at high risk for coronary heart disease (CHD). Understanding these factors can help manage healthcare expenses.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Public Health
Background:
- Socio-economic status, comorbidities, and statin adherence influence the cost-effectiveness of hyperlipidemia treatment.
- Direct medical costs are a key consideration in managing patients at high risk of coronary heart disease (CHD).
Purpose of the Study:
- To assess the impact of demographic, clinical, and statin adherence factors on direct medical costs.
- To identify predictors of healthcare expenditure in Chinese patients at high risk for CHD.
Main Methods:
- Prospective, observational cohort study in Hong Kong.
- Recruited patients on statin monotherapy at high risk for CHD.
- Monitored statin adherence over 6 months using the Medication Event Monitoring System.
- Calculated total direct medical costs per member per month (cPMPM) from a public healthcare perspective.
Main Results:
- 83 patients completed the study; median cPMPM was significantly higher for those experiencing CHD events (USD 444) versus those without (USD 42).
- Predictors of higher cPMPM included history of congestive heart failure, male gender, coronary atherosclerosis, and diabetes mellitus.
Conclusions:
- Male gender, diabetes mellitus, congestive heart failure, and coronary atherosclerosis are significantly associated with increased direct medical costs.
- These findings highlight key demographic and clinical factors influencing healthcare costs in high-risk CHD populations.
Background:
Socio-economic status, comorbidities and adherence to statin therapy might affect the cost-effectiveness of statin therapy in hyperlipidemia.
Objective:
To examine the effects size of demographic factors, clinical factors and adherence to statin therapy on the direct medical costs for Chinese patients at high risk of coronary heart disease (CHD).
Methods:
This was a prospective, observational cohort study conducted in the outpatient departments of a public teaching hospital in Hong Kong. Patients at high risk of CHD who had been on statin monotherapy for < 12 months were recruited. Baseline demographic and clinical data were obtained. Statin adherence was monitored prospectively over 6 months using the Medication Event Monitoring System. Total direct medical costs per member per month (cPMPM), including cost for clinic visits, statin medication, laboratory tests on lipids and management of CHD events if any, were calculated from the perspective of a public healthcare organization.
Results:
83 patients completed the study. Median cPMPM in 80 patients (96% of 83 patients) without a new CHD event (USD 42) and for 3 (4%) patients who experienced CHD events (USD 444) were significantly different (p = 0.003). History of congestive heart failure (beta = 1,957, 95% CI = 1,006 - 2,909), male gender (beta = 584, 95% CI = 215 - 952), coronary atherosclerosis (beta = 1,436, 95% CI = 538 - 2,334) and diabetes mellitus (beta = 604, 95% CI = 136 - 1,07 1) were positive predictors for cPMPM.
Conclusion:
In this pilot study male gender, diabetes mellitus, congestive heart failure and coronary atherosclerosis appear to be significantly associated with higher costs for Chinese patients at high risk of CHD.
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