Abstract 20014: Cost of Hyperkalemia among Patients With Heart Failure
Introduction: Hyperkalemia (HK) is a potentially life-threatening condition known to adversely affect cardiac function, and may cause arrhythmia, myocardial infarction, or stroke. Healthcare costs in patients with HK have not been well characterized.
Hypothesis: HK is associated with a high economic burden, especially in patients with heart failure.
Methods: Adult patients with or without HK (cases vs. controls) were selected from a large US commercial claims database (January 1, 2010 to December 31, 2014). Patients were required to have serum potassium lab results. HK was defined as having at least two serum potassium measurements greater than 5.0 mEq/L or one diagnosis code of HK (ICD-9, 276.7) or one prescription fill of a sodium polystyrene sulfonate. The index date was a randomly selected claim date indicating HK for cases and a randomly selected claim date for controls. Continuous enrollment of at least 6 months before the index date and 12 months after the index date was required. Patients with heart failure were identified by ICD-9 diagnosis codes. Controls were exactly matched one-to-one to cases on age group, stage of chronic kidney disease, dialysis use, heart failure, and Renin-Angiotensin-Aldosterone-System inhibitor use. 30-day and 1-year total healthcare costs (2015 USD) from the third-party perspective were compared between HK cases and controls, in the overall patient population and in patients with heart failure.
Results: A total of 39,626 patients with HK were matched to 39,626 patients without HK. HK cases incurred $4,128 higher 30-day total healthcare costs than controls ($5,994 vs. $1,865) and $15,983 higher 1-year total costs ($31,844 vs. $15,861). Among the 3,789 matched pairs of patients with heart failure, the 30-day total cost difference was $8,327 ($12,718 vs. $4,391) and the 1-year cost difference was $29,574 ($69,211 vs. $39,637). All differences were statistically significant (p less than 0.01). The increases remained statistically significant after regression adjustment.
Conclusions: Patients with hyperkalemia had higher healthcare costs, with even higher costs in patients with heart failure, supporting the hypothesis that hyperkalemia imposes a large economic burden on US payers and the healthcare system.
Author Disclosures: J. Woolley: Employment; Significant; ZS Pharma. Ownership Interest; Significant; AstraZeneca Inc., Amgen Inc. K. Betts: Employment; Significant; Analysis Group, Inc.. Other Research Support; Modest; ZS Pharma. F. Mu: Employment; Significant; Analysis Group, Inc.. Other Research Support; Modest; ZS Pharma. C. Xiang: Employment; Significant; Analysis Group, Inc.. Other Research Support; Modest; ZS Pharma. W. Tang: Employment; Significant; Analysis Group, Inc.. Other Research Support; Modest; ZS Pharma. E. Wu: Employment; Significant; Analysis Group, Inc.. Other Research Support; Modest; ZS Pharma.
- © 2016 by American Heart Association, Inc.