The Cost of Hyperkalemia in the United States

Keith A Betts, J Michael Woolley, Fan Mu, Cheryl Xiang, Wenxi Tang, Eric Q Wu, Keith A Betts, J Michael Woolley, Fan Mu, Cheryl Xiang, Wenxi Tang, Eric Q Wu

Abstract

Introduction: There are limited data on the cost of hyperkalemia.

Methods: This retrospective analysis of the Truven MarketScan claims database assessed the economic burden of hyperkalemia among selected adult patients with hyperkalemia and matched controls.

Results: A total of 39,626 cases (patients with hyperkalemia) were matched to 39,626 controls (patients without hyperkalemia) based on age, dialysis, chronic kidney disease (CKD) stage, heart failure, and renin-angiotensin aldosterone system inhibitor use. Compared with controls, cases incurred $4128 (95% confidence interval [CI] $3893-$4363) higher 30-day total health care costs ($5994 vs. $1865) and $15,983 (95% CI $15,026-$16,940) higher 1-year costs ($31,844 vs. $15,861). Among 11,221 matched pairs of patients with CKD and/or heart failure, cases incurred $5553 (95% CI $5059-$6047) higher 30-day total health care costs ($8165 vs. $2612) and $24,133 (95% CI $21,748-$26,518) higher 1-year costs ($48,994 vs. $24,861) than controls. The multivariable adjusted 1-year total health care cost difference was $15,606 (95% CI $14,648-$16,576) among all patients and $25,156 (95% CI $23,529-$26,757) among patients with CKD and/or heart failure. Cases had higher resource utilization rates including inpatient admissions (30-day: 0.14 vs. 0.03; 1-year: 0.44 vs. 0.19), outpatient visits (30-day: 3.33 vs. 2.28; 1-year: 26.58 vs. 18.53), and emergency department visits (30-day: 0.16 vs. 0.06; 1-year: 0.86 vs. 0.50) (all P < 0.001). When hospitalized, cases stayed 1.51 days (95% CI 1.22-1.80) longer and were 40% more likely to be readmitted.

Conclusion: These data indicate that hyperkalemia is associated with a significant economic burden on afflicted patients and the health care system.

Keywords: costs; health care resource utilization; hospital readmission; hyperkalemia.

Figures

Figure 1
Figure 1
Sample selection. ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification. aPotassium laboratory tests were identified in MarketScan laboratory database based on the Logical Observation Identifiers Names and Code 2823–3. bIf a patient had multiple potential index dates that met all of the inclusion criteria, the index date was randomly selected from the eligible potential index dates. cControls were randomly selected among eligible controls to exactly match 1:1 to cases on age group (18–64 or 65+ years), renin-angiotensin-aldosterone system inhibitors use, dialysis treatment, chronic kidney disease stage (stage 3, stage 4, stage 5, and unspecified stage), and heart failure.
Figure 2
Figure 2
Comparison of all-cause health care costs of patients with hyperkalemia versus matched patients without hyperkalemia.

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Source: PubMed

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