Analyzing the Economic Burden of Neurogenic Orthostatic Hypotension in Patients with Synucleinopathies

There is currently little evidence regarding the economic burden of neurogenic orthostatic hypotension (nOH), which is common in certain neurodegenerative synucleinopathies, such as Parkinson’s disease and dementia. A study sought to evaluate patient demographics, healthcare resource utilization (HCRU), and costs of caring for patients with nOH. The study was published as a poster at AMCP Nexus 2021.

To conduct this study, researchers identified 1,654 patients (mean age 73, 41% women) with nOH associated with an underlying synucleinopathy using the IBM MarketScan Commercial and Medicare Supplemental databases between Jan. 2015, and Dec. 2019. The index date was defined as the first date of nOH diagnosis. To be included in the analysis, patients were required to have at least six months of continuous medical and pharmacy enrollment before the index date (baseline period) and at least 12 months after the index date (follow-up period). The researchers assessed demographics, comorbidities, HCRU, and all-cause costs per patient per month (PPPM). Costs were adjusted to 2020 US dollar inflation. The population of interest included 52.4% patients with Parkinson’s disease, 35.3% with multiple system atrophy, and 12.3% with dementia and Lewy bodies

At baseline, the common comorbidities observed were hypertension (64.1%), cerebrovascular disease (24.6%), congestive heart failure (15.1%), stroke (7.4%), and myocardial infarction (6.6%).

The results showed that in the 12 months after nOH diagnosis, combined medical and pharmacy costs totaled $71,849 per patient and $5,987 PPPM. The researchers noted that the major drivers of costs were inpatient services at $25,486, reflected by 0.88 admissions per patient. The study found that outpatient costs totaled $35,993, including $21,704 for office visits and $3,565 for emergency room visits. Overall, total pharmacy costs were $10,369.

“The economic burden of patients with nOH with underlying synucleinopathies is substantial,” the researchers concluded. That added future research “will estimate the incremental economic burden of nOH relative to a patient population without nOH.”

Source: Pham N, et al. Economic Burden of Neurogenic Orthostatic Hypotension in Patients with Synucleinopathies. Poster G16. Published for AMCP Nexus 2021; Oct. 18-21, 2021, Denver, CO.