A nationwide study of the economic burden of obstructive hypertrophic cardiomyopathy in France

This study describes economic burden of obstructive hypertrophic cardiomyopathy (HCM) in France, with consideration of disease severity as measured by New York Heart Association (NYHA) class.

This observational, retrospective study used data from the French National Health Data System. Adults (≥18) with at least one disease related hospitalization during 2012–18 were included. Patients with <1-year follow-up or phenocopy disorders were excluded. Patients were stratified by disease severity class based on disease specific treatments and symptoms. Healthcare resources use, and costs were estimated per patient-year (PY). Annual cost before and after septal reduction therapies (SRT) was estimated. Overall, 6823 patients were identified (baseline NYHA class I–IV: 4%, 32%, 60%, and 4%, respectively). Mean (standard deviation) follow-up was 4.4 (2.5) years, comprising 30 228 PYs. Total burden was €388 million (€12 824 per PY), and higher NYHA class was associated with higher cost per patient year: €8881 and €22 818 for classes I and IV, respectively. Hospitalizations accounted for most costs (54%); 71% were cardiovascular-related hospitalizations, 46% disease-related. Mean cost per PY was lower 1 year before vs. after SRT, including the intervention (€13 726 vs. €18 565). Mean sick-leave-related costs per PY were €310, €673, €757, and €774 for classes I–IV, respectively.

Obstructive HCM has a high economic burden driven by cardiovascular hospitalizations. Higher disease severity yielded higher costs associated with medical care and sick leave than lower classes. Results support need for new therapies to improve both symptoms and disease severity.