Economic and clinical burden of comorbidities among patients with acromegaly

• Published in: Growth hormone & IGF research 2021-08, Vol.59, p.101389-101389, Article 101389
• Main Authors: Whittington, Melanie D., Munoz, Kathryn A., Whalen, John D., Ribeiro-Oliveira, Antonio, Campbell, Jonathan D.
• Format: Article
• Language: English
• Subjects: Acromegaly; Acromegaly - diagnosis; Acromegaly - economics; Acromegaly - epidemiology; Acromegaly - therapy; Clinical burden; Cohort Studies; Comorbidities; Comorbidity; Costs; Economic burden; Female; Follow-Up Studies; Health Care Costs - statistics & numerical data; Humans; Male; Middle Aged; Prognosis; Quality of Life; United States - epidemiology
• ISSN: 1096-6374; 1532-2238
• DOI: 10.1016/j.ghir.2021.101389

Acromegaly is a rare, pituitary hormonal disorder that requires improved awareness worldwide. The objective of this analysis was to quantify the clinical and economic burden of comorbidities for patients with acromegaly and examine the influence of biochemical control on these outcomes. Markov cohort decision analytic model consisting of two states, including alive (with and without comorbidity) and dead. A cohort of patients with acromegaly who had achieved biochemical control, a cohort of patients with acromegaly who had not achieved biochemical control, and a cohort of individuals from the general US population were tracked over a lifetime time horizon. The model tracked the proportion of the alive population that had each comorbidity based on age, sex, presence of acromegaly, and biochemical control status. The proportion of patients with each acromegaly-associated comorbidity were assigned comorbidity-associated costs, disutilities, and increased risk of mortality. Compared with the general population, controlled acromegaly resulted in $192,000 additional comorbidity-related costs, 0.7 fewer years of life, 2.9 fewer quality-adjusted life years, and 1.1 more comorbidities across the remaining lifespan. Compared with the general population, uncontrolled acromegaly resulted in $285,000 additional comorbidity-related costs, 0.9 fewer years of life, 4.2 fewer quality-adjusted life years, and 1.6 more comorbidities across the remaining lifespan. Achieving biochemical control is associated with improvements in cost, quality of life, and mortality, albeit not to the level of the general population. A multimodal treatment strategy including biochemical control and management of comorbidities is necessary to improve patient outcomes. •Acromegaly is a complex disease associated with numerous comorbidities.•Existing research lacks the contributions of comorbidities to disease burden.•Uncontrolled acromegaly leads to higher costs and fewer years of life.•A multimodal treatment strategy is necessary to improve patient outcomes.