Health Care Resource Use and Economic Burden in Patients With Symptomatic Obstructive Hypertrophic Cardiomyopathy and...

Atrial fibrillation (AF) is common among patients with obstructive hypertrophic cardiomyopathy (oHCM), although the impact of AF on health care resource use and costs is not well defined.

We performed a retrospective analysis of claims data from 2016 to 2021 and used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify adult patients with symptomatic oHCM and classify their status with respect to AF as follows: (1) prevalent AF, (2) incident AF, and (3) no AF. Health care resource use and costs for each cohort were analyzed and expressed as per person per year (PPPY).

Of 22 216 patients with symptomatic oHCM, 6677 had prevalent AF (30.1%), 2879 had incident AF (13.0%), and 12 660 were without AF (57.0%). Patients with incident AF incurred mean total health care costs that were similar to those with prevalent AF but substantially greater than those without AF (mean, $66 619 [95% CI, $59 702-$74 336] versus $63 937 [95% CI, $59 803-$68 356] versus $46 686 [95% CI, $43 901-$49 648] per person per year, P<0.0001). After adjusting for age, sex, major comorbidities, and septal reduction therapy, mean total health care costs remained greater in the groups with incident and prevalent AF than the group without AF, with trends toward even greater relative costs in the group with incident AF. Similar trends were present in adjusted costs related to hospitalizations, surgeries, and urgent care.

The diagnosis of AF in the setting of symptomatic oHCM not only has important implications for patient management but also substantial economic impacts, as it is associated with significantly greater health care costs and resource use relative to patients with symptomatic oHCM and no AF.