Ten year costs of cardiovascular disease in genetically verified familial hypercholesterolemia compared to age and sex matched controls

Background and Aims Available data on economic consequences of carrying an inherited familial hypercholesterolemia (FH) genetic variant are sparse. This study aims to explore the hospital and pharmaceutical resource use, and costs associated with cardiovascular disease (CVD) in patients with genetically verified FH, compared to age-and sex-matched controls during the period 2010 through 2019. Methods We included 5585 individuals with genetically verified FH from the Norwegian Unit for Cardiac and Cardiovascular Genetics registry, and 111483 age- and sex-matched controls from the general Norwegian population. Resource use and costs associated with CVD were collected from the Norwegian Patient Registry, Cause of Death Registry and the Norwegian Prescription Database. We estimated costs in European Euros (EUR, €) based on diagnosis related group (DRG) cost weights and pharmaceutical drug prices (Norwegian Kroner 1 = EUR 0.1015). Results During 2010-2019 patients with FH had CVD-related costs of €3911 per person for hospital care and €6119 for pharmaceuticals compared to €1498 and €514 among controls, respectively. The 10-year costs per person of percutaneous coronary interventions were €561 for FH and €140 for controls. The costs of CVD prescription drugs doubled in the FH population during 2010-19, largely due to the introduction of PCSK9 inhibitors. Costs for prescription drugs increased in both the FH and control populations (p=0.002 for FH and p=0.005 for controls), while costs decreased for hospital care (p=0. 0069 for FH and p=0. 0943 for controls). Conclusions FH patients had about three times higher CVD-related hospital costs, and more than ten times higher pharmaceutical costs than age and sex matched controls during a 10-year follow-up. During the ten years, costs for pharmaceuticals increased and costs for hospital decreased.