Economic Burden of Postsurgical Chronic Hypoparathyroidism: A US Medicare Claims Retrospective Analysis.

Abstract

Introduction: Approximately 75% of hypoparathyroidism (HypoPT) cases result from removal of or injury to parathyroid glands during anterior neck surgery. HypoPT persisting 6 months following surgery carries a significant economic burden. This study aims to describe the economic burden of postsurgical chronic HypoPT in the Medicare population.

Methods: Data from the Medicare 100% Limited Data Set between July 1, 2017, and March 31, 2020, were utilized to identify newly diagnosed adults with a confirmed HypoPT diagnosis (n = 1,166) after surgery (index) and their healthcare resource utilization (HCRU) and costs compared with those of control patients who were non-HypoPT (n = 11,258). Continuous enrollment for ≥ 6 months pre- and ≥ 12 months post-index was required. Individuals with postsurgical chronic HypoPT were matched 1:2 to controls on age, gender, race, region, Charlson Comorbidity Index score, and index year. Three economic burden definitions for HCRU and costs were evaluated in unmatched and matched groups: all-cause, direct HypoPT, and HypoPT plus related long-term complications.

Results: Compared with matched controls (n = 1,107), individuals with postsurgical chronic HypoPT (n = 607) had significant differences in baseline number of hospitalizations (0.53 vs. 0.14), outpatient visits (11.40 vs. 1.51), and total medical costs (US$160,899 vs. $21,288). Over a median of 31 months of follow-up, mean all-cause total medical costs per patient per year (PPPY) were significantly higher among individuals with postsurgical chronic HypoPT ($227,036 vs. $109,306; P < 0.001), largely attributable to higher all-cause medical utilization among the postsurgical chronic HypoPT group (0.72 vs. 0.37 hospitalizations PPPY; 14.4 vs. 7.44 outpatient visits PPPY). Multivariable regression analysis showed that all-cause cost burden among patients with postsurgical chronic HypoPT was 1.57-3.00 times higher, depending on adjustment for baseline renal comorbidities, compared with controls.

Conclusion: The economic burden of postsurgical chronic HypoPT in patients who use Medicare is substantial, highlighting the need for innovative treatments to improve outcomes and quality of life.