Heart Failure -> Cardiac Resynchronization Therapy: -> Surgical & Other D-PO05 - Poster Session V (ID 39) Poster

D-PO05-110 - Real-world Economic Burden Among Patients With And Without Heart Failure Worsening After Cardiac Resynchronization Therapy (ID 1325)


Background: Cardiac resynchronization therapy (CRT) can lead to improved clinical outcomes among patients (pts) with heart failure (HF). However, some pts continue to experience HF worsening after CRT implantation.
Objective: Evaluate all-cause healthcare resource utilization (HRU) and direct healthcare costs in pts with and without HF worsening after CRT.
Methods: Optum’s Clinformatics™ Data Mart Database containing administrative claims from 2007-2018 were used. Pts age ≥18 years with ≥1 claim for CRT, no other cardiac device implantations, and continuous insurance eligibility 180 days prior to and following first claim for CRT (response period) were included. HF worsening was defined as having ≥1 event in Table 1 within 180 days following the first claim for CRT. HRU and costs were assessed for ≥90 days starting on day 181 post-CRT (follow-up) and reported on a per pt per year (PPPY) basis.
Results: Among 12,758 eligible pts, 4,787 (38%) had HF worsening. The most common worsening events were congestive HF hospitalizations (19%) and intensive care unit stays (17%). Mean follow-up was similar in pts with (2.0 years) and without HF worsening (2.1 years). Pts with worsening had numerically higher PPPY rates of hospitalizations (1.31), emergency room visits (0.80), and outpatient visits (14.50) than pts without worsening (0.75, 0.55, and 8.31). Total costs were 1.7 times higher in pts with versus without worsening ($127,754 and $74,571 PPPY). Adjusted comparisons are forthcoming.
Conclusion: Early identification and prevention of HF worsening in pts with CRT is important for reducing economic burden. This may be achieved by CRT optimization.