Abstract
BACKGROUND: Previous studies of patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) have reported worse clinical burden for female patients; whether this translates to an increase in healthcare resource use (HRU) and cost is unknown. Therefore, we evaluated the impact of sex on economic burden in symptomatic oHCM. METHODS: Medical and pharmacy claims data were assessed from 2016 to 2021 to identify (ICD-10 code) adult patients with symptomatic oHCM in the United States. Generalized linear models were used to estimate HCM-related cost and generalized estimating equations for HRU [both reported as mean per-person-per-year (PPPY)] for healthcare categories: inpatient, outpatient, emergency room (ER), urgent care, and pharmacy. Cox proportional hazard regressions were used to compare differences in male and female patients with symptomatic HCM. RESULTS: Among 9,490 patients with symptomatic oHCM, 5,309 (55.9%) were female. Female patients were older (64 ± 13 vs. 59 ± 14), with a higher Charlson Comorbidity Index (1.9 vs. 1.7) compared to males, respectively. After adjusting for patient characteristics, female patients had significantly greater number of HCM-related hospitalizations (0.24 vs. 0.20 PPPY, p = 0.0014), LOS (5.08 vs. 4.30 PPPY; p = 0.0235), number of outpatient visits (4.98 vs. 4.59 PPPY; p = 0.0387), and number of distinct drugs (0.59 vs. 0.55 PPPY; p = 0.0010), compared with males, respectively. In adjusted models, only HCM-related pharmacy costs were significant, with female patients having slightly higher costs compared to males ($70 vs. $61 PPPY; p = 0.0465). There were no significant differences in all-cause costs of care between male and female patients with oHCM. . CONCLUSIONS: Female patients with symptomatic oHCM experience greater rates of HCM-related and all-cause hospitalizations and number of prescriptions, and HCM-related length of stay, outpatient visits, and pharmacy costs compared to male patients.