title: Medical resource use and costs associated with chylomicronemia.
abstract: BACKGROUND
  The prevalence of severe hypertriglyceridemia (TG > 1000 mg/dl) is estimated at 150-400 per 100,000 individuals in North America. Severe hypertriglyceridemia in the fasting state is associated with increased acute pancreatitis risk and is a sign of chylomicronemia which reflects the accumulation in the bloodstream of chylomicrons, the large lipoprotein particles produced in the gut after a meal.
  
  
  OBJECTIVE
  To assess medical resource use and costs associated with chylomicronemia.
  
  
  METHODS
  Patients with chylomicronemia of different causes (≥2 diagnoses with ICD-9 code 272.3) were identified from a large US claims database (years 2000 to 2009) and matched 1:1 to controls free of chylomicronemia based on age, gender, demographics, comorbidities, and use of lipid lowering drugs. During a 1-year study period, medical resource use and costs associated with chylomicronemia or acute pancreatitis were compared between matched cases and controls.
  
  
  RESULTS
  Among 6472 matched pairs, annual per-patient medical costs, calculated independently of the occurrence of acute pancreatitis, were significantly greater by $808 for chylomicronemia cases vs controls ($8029 vs $7220, p < 0.01), half of which was attributable to chylomicronemia-related services (p < 0.01). Chylomicronemia cases with a history of acute pancreatitis (n = 46) had greater rates of inpatient visits (p < 0.05) and greater average costs for subsequent acute pancreatitis or abdominal pain (p < 0.01) as well as greater total medical costs ($33,587 vs $4402, p < 0.01) vs matched controls. The average episode of acute pancreatitis (n = 104 episodes) generated medical costs of $31,820, almost entirely due to inpatient stays.
  
  
  CONCLUSIONS
  Triglyceride levels were not available to characterize disease severity.
  
  
  CONCLUSIONS
  Patients with chylomicronemia, and especially those with a history of acute pancreatitis, incurred significantly greater total medical costs compared with individuals without chylomicronemia but with an otherwise comparable health profile.
authors: Ecogene-21 Clinical Research Center and Department of Medicine, Université de Montréal, Montreal, Canada. daniel.gaudet@umontreal.ca
authors: Daniel
authors: D
authors: Gaudet
authors: James
authors: J
authors: Signorovitch
authors: Elyse
authors: E
authors: Swallow
authors: Liangyi
authors: L
authors: Fan
authors: Karine
authors: K
authors: Tremblay
authors: Diane
authors: D
authors: Brisson
authors: Charles
authors: C
authors: Meyers
authors: Jean-Bernard
authors: JB
authors: Gruenberger
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006954:Hyperlipoproteinemia Type V / Q000150:complications* / Q000188:drug therapy / Q000191:economics*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced / Q000191:economics* / Q000209:etiology*; D062072:Patient Acuity; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D000960:Hypolipidemic Agents