Ikeda Yuika, Yamamoto Tsunehisa, Torigoe Makio, Casaes Teixeira Bruno, Laurent Thomas
Bristol Myers Squibb, Tokyo, Japan.
Bristol Myers Squibb, Uxbridge, UK.
Cardiol Ther. 2025 Mar;14(1):71-86. doi: 10.1007/s40119-024-00396-z. Epub 2025 Jan 15.
Data on the prevalence of hypertrophic cardiomyopathy (HCM), characteristics of patients with HCM, and treatment patterns in Japan are limited. This study aimed to estimate the prevalence of HCM and describe the patient characteristics, treatment patterns, and utilization of medical expense subsidies in Japan, using payer claims data from insurers.
This retrospective study of patients with HCM in Japan utilized payer claims data from insurers (Advanced Elderly Medical Service System [AEMSS], Kokuho, and Kempo) from January 1, 2017, to December 31, 2021. The prevalence of HCM was calculated annually; while medication use, comorbidities, and usage of medical expense subsidies were described for 2021 as representative data.
The estimated prevalence of HCM increased from 9.3/10,000 people in 2017 to 11.1/10,000 people in 2021. In 2021, the highest prevalence was observed in patients aged 85-89 years (39.0/10,000 people). For patients with HCM, mean (standard deviation) age was 82.5 (5.5) years (AEMSS), 66.7 (9.2) years (Kokuho), and 53.4 (14.0) years (Kempo). Hypertension was the most common comorbidity (AEMSS, 90.7%; Kokuho, 85.7%; Kempo, 71.4%), followed by heart failure (AEMSS, 77.3%; Kokuho, 64.4%; Kempo, 56.9%). Mental health disorders were reported in 22.4% (AEMSS), 16.3% (Kokuho), and 11.3% (Kempo) of patients with HCM. Beta-blockers were the most frequently prescribed medications (AEMSS, 65.1%; Kokuho, 63.2%; Kempo, 56.6%). A small proportion of patients whose HCM was diagnosed in 2021 received medical expense subsidies (AEMSS, 2.6%; Kokuho, 4.6%).
This study is the first to evaluate the prevalence of HCM in Japan using data from the general population as the denominator. It indicated that patients with HCM are typically > 50 years old, have a high prevalence of comorbidities, are commonly treated with beta-blockers, and rarely receive medical expense subsidies for designated intractable diseases. About one-fifth of the patients had mental health disorders.
关于肥厚型心肌病（HCM）在日本的患病率、HCM患者的特征以及治疗模式的数据有限。本研究旨在利用保险公司的支付方理赔数据，估算日本HCM的患病率，并描述患者特征、治疗模式以及医疗费用补贴的使用情况。
本项针对日本HCM患者的回顾性研究利用了2017年1月1日至2021年12月31日期间保险公司（老年高级医疗服务系统[AEMSS]、国民健康保险、政府雇员健康保险）的支付方理赔数据。每年计算HCM的患病率；以2021年的数据作为代表性数据，描述药物使用情况、合并症以及医疗费用补贴的使用情况。
HCM的估计患病率从2017年的9.3/万人增至2021年的11.1/万人。2021年，85 - 89岁患者的患病率最高（39.0/万人）。对于HCM患者，平均（标准差）年龄在AEMSS组为82.5（5.5）岁，在国民健康保险组为66.7（9.2）岁，在政府雇员健康保险组为53.4（14.0）岁。高血压是最常见的合并症（AEMSS组为90.7%；国民健康保险组为85.7%；政府雇员健康保险组为71.4%），其次是心力衰竭（AEMSS组为77.3%；国民健康保险组为64.4%；政府雇员健康保险组为56.9%）。22.4%（AEMSS组）、16.3%（国民健康保险组）和11.3%（政府雇员健康保险组）的HCM患者报告有心理健康障碍。β受体阻滞剂是最常处方的药物（AEMSS组为65.1%；国民健康保险组为63.2%；政府雇员健康保险组为56.6%）。2021年被诊断为HCM的患者中只有一小部分获得了医疗费用补贴（AEMSS组为2.6%；国民健康保险组为4.6%）。
本研究首次以普通人群数据为分母评估日本HCM的患病率。结果表明，HCM患者通常年龄大于50岁，合并症患病率高，常用β受体阻滞剂治疗，很少获得指定疑难病的医疗费用补贴。约五分之一的患者有心理健康障碍。
