Disease and Economic Burden Associated with Recurrent Pericarditis in a Privately Insured United States Population

INTRODUCTION: Approximately 30% of patients with a first acute pericarditis episode experience a recurrence ≤ 18 months; ~ 15% experience multiple recurrences. This study assessed the recurrence and economic burden among patients with multiple recurrences. METHODS: Adults with idiopathic pericarditis were identified in the OptumHealth Care Solutions, Inc. , database (2007-2017). Recurrent pericarditis (RP) was defined as ≥ 2 episodes of care separated by > 28 days; multiple recurrences were defined as ≥ 2 recurrences. RESULTS: Among 944 patients with RP, 375 (39. 7%) experienced multiple recurrences and were propensity score-matched 1: 1 to 375 patients without recurrence. Among patients with multiple recurrences, median disease duration (time from first episode to end of last recurrence, confirmed by a 1. 5-year recurrence-free period) was 2. 84 years. The multiple recurrences cohort had higher rates of hospitalizations per-patient-per-month (PPPM) than the no recurrence cohort (rate ratio 95% confidence interval (CI) = 2. 22 1. 35-3. 65). Mean total healthcare costs were significantly higher in the multiple recurrences versus no recurrence cohort (2728 vs. 1568 PPPM, cost ratio 95% CI = 1. 74 1. 29-2. 32), mainly driven by higher hospitalization costs in the multiple recurrences cohort (mean: 1180 vs. 420 PPPM, cost ratio 95% CI = 2. 81 1. 80-4. 66). Mean work loss costs were higher in the multiple recurrences versus no recurrence cohort (696 vs. 169 PPPM, cost ratio 95% CI = 4. 12 1. 64-9. 61). In patients with multiple recurrences, mean cost of the first episode was 19, 189; subsequent recurrences ranged from 2089 to 7366 (second recurrence = 6222). CONCLUSION: In conclusion, among patients with multiple pericarditis recurrences, disease symptoms persisted several years, and healthcare and work loss costs were further compounded in this subset of patients.