Abstract 18529: Trends in Direct Healthcare Expenditures Among US Adults With Atherosclerotic Cardiovascular Disease: Analysis of the Medical Expenditure Panel Survey From 2002 to 2013
Introduction: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death in the US with substantial financial burden at an individual and national level. We aimed to explore the trends in costs by expenditure category in U.S. adults with ASCVD between 2002 and 2013.
Methods: Data were obtained annually from 2002-2013 using publicly-available household component and consolidated data files of Medical Expenditure Panel Survey (MEPS) database. ASCVD diagnoses (coronary artery disease, peripheral artery disease & stroke) were ascertained by ICD-9-CM codes and self-report. Individuals < 40 years of age and BMI < 18.5 kg/m2 were excluded. All analyses took into account MEPS complex design and costs were adjusted to 2013 USD using Gross Domestic Product Index.
Results: Among U.S. adults, ASCVD prevalence rose from 13% in 2002-03 to 16% in 2012-13. Over the same period, estimated unadjusted total direct expenditures for individuals with ASCVD increased from $213.9 billion/year to $298.5 billion to $284.1 billion, accounting for 32% of all healthcare spending in adults ≥ 40. Relative to individuals without ASCVD ($5,138 [95% CI 5019-5256]), individuals with ASCVD ($14,064 [95% CI 13656-14472]) had more than twice the unadjusted mean direct expenditures over the 12-year period (Table). Even after adjusting for confounders, individuals with ASCVD had $3,971 (95% CI 3681-4260) higher direct annual expenditures compared to those without ASCVD.
Conclusions: Our study findings inform policymakers on the continued immense economic burden among those with established ASCVD. These trends, particularly the contribution of prescription medications, underscore the importance of preventive efforts to mitigate the burden of ASCVD and associated excessive expenditures at a national level.
Author Disclosures: J. Valero-Elizondo: None. J.A. Salami: None. H.J. Warraich: None. C.U. Osondu: None. E.S. Spatz: None. N. Desai: None. J.S. Rana: None. S.S. Virani: None. R. Blankstein: None. M.J. Blaha: None. A. Khera: None. K. Nasir: Consultant/Advisory Board; Modest; Quest Diagnostic, Regeneron.
- © 2016 by American Heart Association, Inc.