Browsing by Author "Fox, Kathleen M"

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    Citation - WoS: 40
    Citation - Scopus: 38
    Clinical and Economic Burden Associated With Cardiovascular Events Among Patients With Hyperlipidemia: a Retrospective Cohort Study
    (2016) Wang, Li; Quek, Ruben G. W; Fox, Kathleen M; Gandra, Shravanthi R; Li, Lu; Başer, Onur
    Background: Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia. Methods: Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate-and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period). Results: Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75 % of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE. Conclusions: Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.
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    Citation - WoS: 2
    Pcv58 - Long-Term Economic Burden Associated With Cardiovascular Events Among High-Risk Patients With Hyperlipidemia
    (2015) Fox, Kathleen M; Wang, Li; Gandra, S. R; Quek, R. G. W; Li, L; Başer, Onur
    Objectives: This study evaluated the economic burden associated with new cardiovascular events (CVEs) for 3 years post-CVE among high-risk patients diagnosedwith hyperlipidemia. Methods: A retrospective cohort study was conductedamong high-risk hyperlipidemic patients with and without a new CVE, using IMSLifeLink PharMetrics Plus data 01/01/2006-06/30/2012. CVEs included primary inpatient claims for myocardial infarction, unstable angina, ischemic stroke, transientischemic attack, revascularization and heart failure. Patients were assigned torisk cohorts based on history of CVE and coronary heart disease risk equivalent(CHD RE) condition. Propensity score matching was applied to compare healthcarecosts among patients with and without new CVEs, ranging from 1 month (acutephase) to 3 years post-CVE date. Results: A total of 21,482 matched patientswere included in the history of CVE cohort and 181,228 in the CHD RE cohort.Hyperlipidemic patients with new CVEs were, on average, aged 65-72 years, bothcohorts had 65.2% male and 74.7-84.4% had hypertension (most common baselinecomorbidity). Total costs per patient per month (PPPM) were significantly higheramong patients with versus without new CVEs during the acute phase (history ofCVE: $27,247 vs. $1,586; CHD RE: $30,742 vs. $914; p<0.0001) and remained higherduring years 1, 2 and 3, respectively, post-CVE among patients in the history of CVEcohort ($2,603 vs. $1,252; $2,055 vs. $1,191; $2,061 vs. $1,166, p<0.0001) and CHD REcohort ($1,926 vs. $844; $1,535 vs. $850; $1,475 vs. $853, p<0.0001). Significant costdifferences were observed between patients with and without new CVEs in bothcohorts, including inpatient, outpatient, emergency room and pharmacy visit costsPPPM, during 1-3 years post-CVE. Conclusions: Healthcare costs for high-riskpatients with new CVEs remained significantly higher than for matched patients without CVEs for up to 3 years post-CVE, imposing a significant economic burdenon U.S. commercial payers.