Real world evidence on health care resource utilization and economic burden of arrhythmias in patients with COPD

Cardiac arrhythmias are common in chronic obstructive pulmonary disease (COPD) and are associated with poor outcomes. Their impact on healthcare resource utilization (HCRU) and costs is increasingly recognized. The incremental economic burden of arrhythmias in patients with COPD and the impact of early detection using ambulatory electrocardiogram (AECG) monitors remain unknown. This real-world analysis quantified incremental HCRU, costs associated with arrhythmia in COPD, and the impact of early detection through AECG monitoring. We conducted a retrospective claims analysis using the Merative MarketScan database (2006-2024) to identify patients with COPD aged > 18 years. We examined three sub-cohort pairs of these patients, with and without arrhythmia, and those who underwent AECG monitoring, comparing demographics, hospitalization rates, all-cause readmissions within 30 days, emergency room visits, and total care costs. Each cohort pair was reweighted using entropy balancing on the following baseline variables: age, sex, region, insurance type, and comorbidities. The HCRU and cost drivers were analyzed over 24 months from the index date, and significance was assessed using Tweedie distributions for costs and zero-inflated binomial distributions for HCRU rates. Healthcare costs and HCRU were significantly higher in the 71,585 patients with COPD and arrhythmia than in the 261,188 matched patients without arrhythmia. In the second comparison, patients with COPD and arrhythmia who were monitored using AECG had a higher utilization rate than their counterparts who did not have arrhythmia. In the third comparison, patients with COPD and arrhythmia who were monitored using AECG had lower utilization than their counterparts who were never monitored. As a retrospective analysis of claims data, this study was limited by the population under investigation and the availability of the measured variables. Arrhythmias in COPD substantially increase healthcare utilization and costs. Early detection by AECG monitoring may mitigate this burden.