Zhang Donglan, Wang Guijing, Fang Jing, Mercado Carla
Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA.
Med Care. 2017 Jan;55(1):4-11. doi: 10.1097/MLR.0000000000000663.
Hyperlipidemia is a major risk factor for cardiovascular disease (CVD), affecting 73.5 million American adults. Information about health care expenditures associated with hyperlipidemia by CVD status is needed to evaluate the economic benefit of primary and secondary prevention programs for CVD.
The study sample includes 48,050 men and nonpregnant women ≥18 from 2010 to 2012 Medical Expenditure Panel Survey. A 2-part econometric model was used to estimate annual hyperlipidemia-associated medical expenditures by CVD status. The estimation results from the 2-part model were used to calculate per-capita and national medical expenditures associated with hyperlipidemia. We adjusted the medical expenditures into 2012 dollars.
Among those with CVD, per person hyperlipidemia-associated expenditures were $1105 [95% confidence interval (CI), $877-$1661] per year, leading to an annual national expenditure of $15.47 billion (95% CI, $5.23-$27.75 billion). Among people without CVD, per person hyperlipidemia-associated expenditures were $856 (95% CI, $596-$1211) per year, resulting in an annual national expenditure of $23.11 billion (95% CI, $16.09-$32.71 billion). Hyperlipidemia-associated expenditures were attributable mostly to the costs of prescription medication (59%-90%). Among people without CVD, medication expenditures associated with hyperlipidemia were $13.72 billion (95% CI, $10.55-$15.74 billion), higher in men than in women.
Hyperlipidemia significantly increased medical expenditures and the increase was higher in people with CVD than without. The information on estimated expenditures could be used to evaluate and develop effective programs for CVD prevention.
高脂血症是心血管疾病（CVD）的主要危险因素，影响着7350万美国成年人。需要了解按CVD状态划分的与高脂血症相关的医疗保健支出信息，以评估CVD一级和二级预防项目的经济效益。
研究样本包括2010年至2012年医疗支出面板调查中48050名年龄≥18岁的男性和非孕女性。采用两部分计量经济学模型按CVD状态估计与高脂血症相关的年度医疗支出。两部分模型的估计结果用于计算与高脂血症相关的人均和全国医疗支出。我们将医疗支出调整为2012年的美元价值。
在患有CVD的人群中，每人每年与高脂血症相关的支出为1105美元[95%置信区间（CI），877 - 1661美元]，导致全国年度支出为154.7亿美元（95% CI，52.3 - 277.5亿美元）。在没有CVD的人群中，每人每年与高脂血症相关的支出为856美元（95% CI，596 - 1211美元），导致全国年度支出为231.1亿美元（95% CI，160.9 - 327.1亿美元）。与高脂血症相关的支出主要归因于处方药费用（59% - 90%）。在没有CVD的人群中，与高脂血症相关的药物支出为137.2亿美元（95% CI，105.5 - 157.4亿美元），男性高于女性。
高脂血症显著增加了医疗支出，且患有CVD的人群增加幅度高于未患CVD的人群。估计支出信息可用于评估和制定有效的CVD预防项目。
