MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC.
Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT.
J Clin Lipidol. 2019 Sep-Oct;13(5):754-761. doi: 10.1016/j.jacl.2019.07.004. Epub 2019 Jul 20.
Hypertriglyceridemia (HTG) is associated with increased cardiovascular disease (CVD) risk. However, the cost burden of HTG-related CVD in high-risk US adults on statins has not been well characterized.
We estimated the HTG-related health care cost burden among US adults with CVD or diabetes taking statin therapy.
We estimated population sizes and annual health care costs among US adults aged ≥45 years with diabetes or CVD taking statin therapy with normal triglycerides (TGs) defined as TG < 150 mg/dL compared with those with HTG defined as TG ≥ 150 mg/dL. Population sizes were estimated from the 2007-2014 National Health and Nutrition Examination Surveys. Adjusted mean total annual health care costs in 2015 US dollars were estimated using the Optum Research Database. The annual total health care cost burden was estimated by multiplying the population size by the mean annual total incremental health care costs overall and within subgroups.
There were 6.2 (95% confidence interval [CI], 5.4 - 7.1) million and 12.0 (95% CI, 11.1 - 12.9) million US adults aged ≥45 years with diabetes and/or CVD on statin therapy with TG ≥ 150 mg/dL and TG < 150 mg/dL, respectively. The mean adjusted incremental total one-year health care costs in adults with TG ≥ 150 mg/dL compared with those with TG < 150 mg/dL was $1730 (95% CI, $1160 - $2320). This leads to a projected annual incremental cost burden associated with HTG in patients with diabetes or CVD on statins of $10.7 billion (95% CI, $6.8 B - $14.6 B).
In US adults on statins and at high risk for CVD, the health care costs associated with HTG are substantial.
高甘油三酯血症（HTG）与心血管疾病（CVD）风险增加相关。然而，他汀类药物治疗的高危美国成年人中与 HTG 相关的 CVD 的成本负担尚未得到充分描述。
我们评估了接受他汀类药物治疗的患有 CVD 或糖尿病的美国成年人中与 HTG 相关的医疗保健成本负担。
我们评估了年龄≥45 岁、接受他汀类药物治疗且甘油三酯（TG）正常（定义为 TG<150mg/dL）的美国成年人与 TG≥150mg/dL 的 HTG 患者相比，CVD 或糖尿病患者的人口规模和年度医疗保健成本。人口规模是根据 2007-2014 年全国健康和营养调查估计的。使用 Optum Research Database 估计了 2015 年以美元为单位的调整后平均年度总医疗保健成本。通过将人口规模乘以总体和亚组内的平均年度总增量医疗保健成本来估算年度总医疗保健成本负担。
分别有 620 万（95%置信区间[CI]，5.4-7.1）和 1200 万（95%CI，11.1-12.9）名年龄≥45 岁、接受他汀类药物治疗且 TG≥150mg/dL 和 TG<150mg/dL 的患有糖尿病和/或 CVD 的美国成年人。与 TG<150mg/dL 的成年人相比，TG≥150mg/dL 的成年人调整后的增量总一年医疗保健成本平均为 1730 美元（95%CI，1160-2320 美元）。这导致他汀类药物治疗的糖尿病或 CVD 患者中与 HTG 相关的每年增量成本负担预计为 107 亿美元（95%CI，680 亿至 1460 亿美元）。
在接受他汀类药物治疗且 CVD 风险较高的美国成年人中，与 HTG 相关的医疗保健成本相当可观。
