title: Hospital use and medical care costs up to 5 years after triglyceride lowering among patients with severe hypertriglyceridemia.
abstract: BACKGROUND
  Severe hypertriglyceridemia is associated with resource-intensive conditions such as cardiovascular disease, diabetes, and pancreatitis. Whether triglyceride (TG) reduction reduces annual medical costs has not been studied.
  
  
  OBJECTIVE
  The objective was to compare medical care costs after changes in triglyceride levels for up to 5 years of follow-up.
  
  
  METHODS
  Using an observational cohort, we identified 808 individuals who had a baseline TG level ≥500 mg/dL in calendar year 2004 and had a second measure 6 to 24 weeks later. We collected all subsequent inpatient, outpatient, and pharmacy use and medical cost data through 2009. Percentage change from baseline TG level was used to create six categories: decreased ≥60%, 45%-59%, 30%-44%, 15%-29%, 0%-14%, and TG increase. We estimated and compared annualized medical care costs by adjusting for baseline costs, baseline TG, high-density lipoprotein, and low-density lipoprotein cholesterol levels, age, sex, smoking status, body mass index, blood pressure, and presence of comorbidities such as diabetes and cardiovascular disease.
  
  
  RESULTS
  Mean age of the cohort was 55.9 ± 11.7 years and 66% were men. Patients who reduced their TG levels by ≥60% experienced a mean annualized reduction from baseline medical costs of $471, whereas costs increased in all other TG change categories. Between-group differences were most pronounced in the first three years, but none were statistically significant.
  
  
  CONCLUSIONS
  This observational study was unable to establish that TG lowering among patients with severe hypertriglyceridemia produced statistically significantly lower hospital use or medical care costs. However, the nonsignificant trends observed suggest that a larger study conducted with controlled TG lowering may be warranted.
authors.affiliation: Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227-1098, USA. greg.nichols@kpchr.org
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Nichols
authors.forename: Bhakti
authors.initials: B
authors.lastname: Arondekar
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
mesh_terms: D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D000960:Hypolipidemic Agents; D014280:Triglycerides