High-risk atherosclerotic cardiovascular disease in a real-world employed japanese population: Prevalence, cardiovascular event rates, and costs

Abstract

Aim: To assess the prevalence of high-risk atherosclerotic cardiovascular disease (ASCVD, defined as history of acute coronary syndrome [hACS], cerebrovascular atherosclerotic disease [CeVAD], peripheral artery disease [PAD], or coronary artery disease w/diabetes [CADD] and associated costs and cardiovascular (CV events in Japan. Methods: A retrospective analysis was conducted using the Japan Medical Data Center (JMDC database (2006 – 2011. ASCVD prevalence was estimated on the basis of diagnoses for CeVAD, PAD, CADD, and hACS (ACS claim >30–≤365 days after ACS-related hospitalization during 1/1/ 2008– 12/31/2009. Population denominators used in the prevalence estimations were provided by JMDC. A subcohort with an insurance coverage for ≥12 months before and ≥24 months after first/ index ASCVD claim during 1/1/2008–12/31/2009 were analyzed on the basis of costs (in 2012 US dollars and events. Results: ASCVD prevalence was 1,869/100,000 population. In total, 8,112 patients met inclusion criteria for the cost and CV event analyses. Among these patients, 4.0% experienced any event (myocardial infarction, stroke, coronary revascularization, hospitalization for unstable angina in the year after ASCVD diagnosis, which decreased to 2.2% in year 2. First-year event rates were highest (22% in patients with hACS. Mean [SD] all-cause costs per patient in year 1 were $7,031 [$14,359] for all patients with ASCVD combined. Extrapolated to the entire employed population, total first-year costs were estimated at $8.2 billion. Conclusions: ASCVD is not rare in Japan, even within a relatively young population of employed persons. Further, the total direct first-year cost burden of ASCVD in the employed Japanese population is high. These data may inform future economic assessments of new ASCVD treatments.