Transthyretin Amyloid Cardiomyopathy Exacts Higher Costs and Resource Use Compared to Non-Amyloid Heart Failure

A study presented at the 2024 AHA Scientific Sessions highlights the significant healthcare resource utilization (HCRU) and costs associated with transthyretin amyloid cardiomyopathy (ATTR-CM), underscoring its burden compared to non-amyloid heart failure (HF). Led by UTSW’s Justin L. Grodin and colleagues, the research leverages real-world claims data to quantify the differences in resource demands between these two populations.

ATTR-CM is a progressive, fatal condition marked by heart failure, arrhythmias, and other systemic manifestations. Its economic impact has been hypothesized to exceed that of non-ATTR HF, but comparative data specific to the U.S. healthcare system have been limited. This study aimed to fill this gap by examining hospitalization rates, length of stay, and associated costs.

Using the Optum Clinformatics Data Mart (2016-2023), the study identified 4,581 patients with ATTR-CM based on a diagnosis of heart failure or cardiomyopathy within two years of amyloidosis diagnosis. These patients were matched 1:1 with non-ATTR HF patients using propensity score matching. Both cohorts were assessed over a minimum 12-month follow-up for cardiovascular-related hospitalizations (CVH), mean hospitalization days, and costs.

Patients with ATTR-CM had significantly greater HCRU and costs compared to those with non-ATTR HF:

• Hospitalizations: ATTR-CM patients experienced a higher number of total cardiovascular hospitalizations annually (p<0.001), with an average of 2.3 additional days spent in the hospital per year compared to non-ATTR HF patients.
• Costs: The mean cost per hospitalization and the annual cost per patient for hospitalizations were significantly higher for ATTR-CM (p=0.00463 and p<0.001, respectively).
• Length of Stay: ATTR-CM patients were hospitalized longer annually for cardiovascular reasons, reflecting more severe disease and intensive management needs.

Takeaways

This study establishes ATTR-CM as a substantial economic and healthcare burden relative to non-ATTR HF. Higher hospitalization rates, extended lengths of stay, and elevated costs per hospitalization emphasize the need for early diagnosis, disease-modifying therapies, and multidisciplinary care to mitigate its impact. These findings provide critical data for clinicians, healthcare systems, and payers in optimizing resource allocation and patient care strategies for this growing population.

Reference

Grodin J, Masri A, Wright R, et al. Costs and Healthcare Resource Utilization in Transthyretin Amyloid Cardiomyopathy Exceeds That of Non-amyloid Heart Failure. Presentation #MDP875. Presented at the American Heart Association Scientific Sessions 2024; November 16-18, Chicago, Illinois.