Chronic hypoparathyroidism linked to higher medical costs: US study
Economic burden greater for patients with long-lasting issues after surgery
Long-lasting hypoparathyroidism following surgery is associated with more hospitalizations and higher healthcare-related medical costs compared with temporary hypoparathyroidism after surgery, a new U.S. study shows.
The higher medical costs linked to such chronic disease were found to create a greater economic burden for patients, according to researchers. For one example, overall costs in the first year after surgery averaged more than $15,000 for chronic disease patients versus less than $3,000 for those with transient hypoparathyroidism.
“Chronicity of [hypoparathyroidism] appears to contribute to higher utilization of healthcare services and incurred healthcare costs compared to patients with transient disease,” the researchers wrote, adding that “these findings suggest a need for improved management and treatment of [chronic hypoparathyroidism].”
The study, “Economic burden of patients with post-surgical chronic and transient hypoparathyroidism in the United States examined using insurance claims data,” was published in the Orphanet Journal of Rare Diseases.
The work was funded in part by Amolyt Pharma, which recently was purchased by AstraZeneca. The deal meant that eneboparatide, an experimental treatment for chronic hypoparathyroidism currently in Phase 3 clinical testing, is now in the pipeline of Alexion, AstraZeneca Rare Disease.
More specialist visits for those with chronic hypoparathyroidism
Hypoparathyroidism is most commonly caused by damage to or removal of the parathyroid glands, a set of small glands in the neck that are responsible for making parathyroid hormone. That hormone helps regulate levels of calcium and other nutrients in the body. The condition most often develops after neck surgery. Post-surgery hypoparathyroidism can be classified as transient (temporary) or chronic (long-lasting).
As with any health condition, hypoparathyroidism can be costly to manage; however, there is little published data on healthcare costs associated with hypoparathyroidism that develops after surgery.
Now, researchers at Amolyt and their collaborators delved into the overall medical costs related to this disease using data from a large U.S. health insurance claims database.
The analysis included data on more than 2,000 individuals who developed post-surgical hypoparathyroidism between 2014 and 2019. Among the patients, 1,406 had chronic hypoparathyroidism with disease-related claims extending for six months or longer after surgery, while the other 773 had transient hypoparathyroidism lasting less than six months. In both groups, most patients were female and the average age was in the early 50s.
[Overall,] throughout the study period, the [chronic hypoparathyroidism] cohort experienced nearly double the number of all-cause emergency room visits and inpatient hospitalizations than the [transient hypoparathyroidism] cohort.
In the first year after the hypoparathyroidism diagnosis following surgery, rates of hospitalizations and clinical visits were, overall, similar in patients with chronic or transient hypoparathyroidism.
But in the second year, those with chronic disease had somewhat more inpatient hospitalizations (17.4% vs. 14.4%) and emergency department visits (26% vs. 21.4%). Patients with chronic hypoparathyroidism also had notably higher rates of visits to specialists like endocrinologists or cardiologists.
Overall, “throughout the study period, the [chronic hypoparathyroidism] cohort experienced nearly double the number of all-cause emergency room visits and inpatient hospitalizations than the [transient hypoparathyroidism] cohort,” the researchers wrote.
Medical costs at pharmacy dramatically higher with chronic condition
Chronic hypoparathyroidism patients also had notably higher healthcare-related costs in the first year than those with transient disease: $15,545 versus $2,731. The difference in pharmacy-related costs was particularly dramatic — on average, patients with chronic disease accrued more than $6,000 in pharmacy costs, whereas those with transient disease had pharmacy costs of less than $150.
In the second year, all-cause healthcare costs tended to decrease in both groups. Still, however, patients with chronic disease had substantially higher average costs than those with transient disease in the second year ($12,153 vs. $305). This difference was mainly driven by outpatient visits and pharmacy costs.
“Using a database including claims from patients covered by commercial, Medicare, and Medicaid plans … we find that patients with post-surgical [chronic hypoparathyroidism] have substantially greater [healthcare resource utilization] and cost burden than those with post-surgical [transient hypoparathyroidism],” the researchers concluded. Medicaid and Medicare are government-funded programs; Medicaid is for low-income families and Medicare is for the elderly and certain people with disabilities.
The researchers noted that this study was limited only to data from insurance claims, so the analysis was not able to account for clinical factors like how well each patient’s disease was being controlled or details on co-occurring health problems.
“Future studies are required to better understand the economic impact associated with [chronic hypoparathyroidism] complications and [co-existing conditions], and to investigate ways to reduce overall burden of disease and costs,” the scientists concluded.
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