Abstract Background Aging people living with HIV (PLWH) have higher prevalence and increased risk of comorbidities such as cardiovascular disease (CVD). This study assessed incremental all-cause healthcare resource utilization (HCRU) and costs among PLWH with and without CVD in the US. Methods A retrospective analysis of US administrative claims (Jan 2020-Dec 2022, Optum’s de-identified Clinformatics® Data Mart Database) examined all-cause HCRU and costs among adult (≥ 18 years) PLWH with ≥ 1 pharmacy claim for anchor antiretroviral therapy (ART) agent (NNRTI, PI, or INSTI) in 2021 (index date: earliest anchor ART claim). PLWH were followed to the earliest of 12 months or end of continuous enrollment and stratified into 2 groups based on the presence of CVD (yes/no) during baseline (12 months pre-index) using ICD-10 diagnosis codes from medical claims. Multivariable generalized linear models with negative binomial/Poisson distribution (HCRU) and gamma distribution (costs) estimated differences in all-cause per-patient-per-month (PPPM) HCRU and costs (adjusted to 2023 USD) between groups, adjusting for baseline characteristics. Results Of 22, 402 PLWH identified, 4, 917 (22%) had CVD. PLWH with vs. without CVD were older (mean age 61. 45 vs. 52. 86 years), more were women (22% vs. 18%) and Black (32% vs. 30%), and had higher mean Quan-Charlson Comorbidity Index scores (2. 85 vs. 0. 87) and baseline total costs (5, 574 vs. 3, 442) ; all p 0. 001. Unadjusted all-cause PPPM HCRU and costs were significantly higher in PLWH with vs. without CVD (all p 0. 001; Table). In multivariable analyses, PLWH with vs. without CVD had significantly greater all-cause PPPM HCRU, total costs (9% higher), medical costs (67% higher), and inpatient costs (72. 3% higher) (all p 0. 001; Table). Conclusion PLWH with CVD experience a greater HCRU and cost burden than those without CVD. Identifying modifiable CVD risk factors (e. g. , hypertension, type 2 diabetes mellitus) along with providing individualized HIV care might mitigate increases in HCRU and costs while optimizing care for PLWH. Disclosures Sean P. Fleming, PhD, MSW, Merck & Co. , Inc. , Rahway, NJ, USA: Employee|Merck & Co. , Inc. , Rahway, NJ, USA: Stocks/Bonds (Public Company) Shweta Kamat, MS, PhD, Merck & Co. , Inc. , Rahway, NJ, USA: Contracted research Girish Prajapati, M. B. B. S. , MPH, Merck & Co. , Inc.: Employee|Merck & Co. , Inc.: Stocks/Bonds (Private Company) Viktor Chirikov, MS, PhD, Merck & Co. , Inc. , Rahway, NJ, USA: Contracted research Wenying Quan, MS, Merck & Co. , Inc. , Rahway, NJ, USA: Contracted research Mark Bounthavong, PharmD, PhD, Merck & Co. , Inc. , Rahway, NJ, USA: Consultant|University of California, San Diego: Employment
Fleming et al. (Thu,) studied this question.