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Volume 3, Issue 6, Pages 403-415 (November 2009)


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Costs associated with cardiovascular events in patients with hypertension in US managed care settings

Mei Sheng Duh, MPH, ScDaCorresponding Author Informationemail address, Nicole M. Fulcher, MAa, Leigh Ann White, PhDa, Sujata S. Jayawant, PhDa, Priyanka Ramamurthy, BAa, Erick Moyneur, MAa, Siew Hwa Ong, MScb

Received 12 June 2009; accepted 8 September 2009.

Abstract 

Study quantified incremental cost of cardiovascular (CV) events in 6 high-risk and compelling indication subgroups: post-myocardial infarction (MI), diabetes, diabetic nephropathy, elderly, chronic kidney disease, and prior stroke. Based on claims data from privately insured individuals with 2+ hypertension (HTN) diagnoses in 2004–2006, we estimated regression-adjusted per-member-per-month healthcare costs after CVE. Costs were compared between patients with and without a CV events, and before and after CV events in each subgroup. The following CVevents were studied: acute MI, acute coronary syndrome, angina, ventricular arrhythmia, atrial arrhythmia, heart failure, coronary artery disease, left ventricular hypertrophy, stroke, and sinus tachycardia. Of 1,598,890 HTN patients, 510,118 had ≥1 CV event. Compared with controls, healthcare costs among patients with events were significantly greater across all cost components (inpatient, outpatient, and prescription drug). Acute MI and congestive heart failure generally had the largest incremental total healthcare costs. First-quarter post-event costs were attributable to inpatient costs. CV events are costly sequelae of hypertension in high-risk and CI subgroups.

a Analysis Group, Inc., Boston, Massachusetts, USA

b Global Health Economics & Outcomes Research, Novartis Pharma AG, Basel, Switzerland

Corresponding Author InformationCorresponding author: Mei Sheng Duh, MPH, ScD, Analysis Group, Inc., 111 Huntington Avenue, 10th Floor, Boston, Massachusetts 02199. Tel: 617-425-8131; fax: 617-425-8001.

 This study was funded by Novartis Pharma AG, Basel, Switzerland. The results of the study were not contingent on the funding.

 Conflict of interest: none.

PII: S1933-1711(09)00106-5

doi:10.1016/j.jash.2009.09.001


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