Hypoparathyroidism: clinical profiles, healthcare use, and costs from real-world data from Italy

To describe the epidemiological, clinical, and healthcare profiles of treated hypoparathyroidism in Italy and to evaluate healthcare resource utilization and direct costs.

Patients with hypoparathyroidism between 2016 and 2022 were identified from the ReS administrative database (∼5.5 million Italian citizens of various regions) through an algorithm based on exemption codes, pharmaceutical consumption, hospital diagnosis/procedures, and emergency department (ED) access. The disease prevalence was determined. Demography, clinical characteristics, 1-year healthcare resource utilization (pharmaceuticals, hospitalizations, ED accesses, and outpatient services), and direct costs were analyzed for the cohort of treated patients and for a sub-cohort with higher treatment intensity (HTI) (i.e. with high-dose of calcium/calcitriol).

Hypoparathyroidism's annual prevalence ranged from 25.5 to 27.6 per 100,000, with a higher prevalence among middle-aged females. The treated patient cohort (n = 2,791) and the sub-cohort with HTI (n = 662) were identified. Among treated patients, 75.2% had at least one comorbidity and 22.2% had three or more; these percentages were higher in the sub-cohort. A widespread consumption of calcium and/or vitamin D was observed in both cohorts, whereas other treatments were scarcely used. Hospitalization and ED access rates were 24.2 and 24.7%, respectively, for the main cohort and 37.8 and 32.5%, respectively, for the sub-cohort. Mean annual per-patient costs were €2,885 for the main cohort and €3,791 for the sub-cohort.

Hypoparathyroidism, due to its chronicity and complex comorbidity profile, represents a substantial and long-term source of healthcare expenditure. These findings highlight an unmet need, particularly for HTI patients, requiring more specific therapies to improve outcomes.