Category: Huntington's Disease
Objective: Examine healthcare resource utilization (HRU) and costs among US Medicare beneficiaries with late-onset Huntington’s disease (LoHD).
Background: Huntington’s disease (HD) is a genetic, neurodegenerative disease that typically manifests at 30–50 years of age; however, LoHD can occur among older individuals aged ≥60 years. Limited evidence exists for the burden of illness in LoHD.
Method: This was a retrospective longitudinal cohort study using 2008–2017 Medicare Research Identifiable Files (100%). We identified Medicare beneficiaries with newly diagnosed LoHD, defined as having ≥1 medical claim with an HD diagnosis (ICD-9-CM: 333.4; ICD-10-CM: G10) between 2009 and 2014, aged ≥60 years at first HD diagnosis (index date) and no HD claims for 1 year pre-index. Beneficiaries without HD (controls) were identified using a 5% random sample of Medicare beneficiaries and matched 1:1 (age, sex, geographic region, index year) to patients with LoHD. All beneficiaries had continuous enrollment in Medicare fee-for-service for 1 year pre- and 3 years post-index. All-cause HRU and costs (2017 US dollars) were measured over 3 years post-index and compared using chi-square (categorical variables) and t-tests (continuous variables).
Results: A total of 2,652 beneficiaries were included (LoHD, n=1,326; controls, n=1,326). Mean (standard deviation [SD]) age was 74.7 [7.4] years, and 64.4% of beneficiaries were female. LoHD beneficiaries had higher mean [SD] Charlson Comorbidity Index (2.5 [2.6] vs. 1.9 [2.2]) and prevalence of anxiety (22.8% vs. 12.2%), dementia (12.3% vs. 2.9%) and depression (6.9% vs. 2.6%) compared with controls. At Year 1 post-index, LoHD beneficiaries had significantly higher utilization of: antidepressants (45.9% vs. 25.3%), anxiolytics (12.7% vs. 8.4%), hospitalizations (31.9% vs. 15.9%), emergency department visits (36.1% vs. 22.8%), and higher mean total costs ($28,863 [SD=$36,937] vs. $13,923 [$24,146]) compared with controls, driven by higher mean outpatient costs ($12,285 [$14,299] vs. $6,796 [$9,720]); all p<0.001. At Years 2–3 post-index, HRU and costs remained significantly higher among LoHD beneficiaries compared with controls.
Conclusion: LoHD Medicare beneficiaries had higher HRU and costs compared with controls over 3 years post-index.
To cite this abstract in AMA style:
J. Ta, S. Reiss Reddy, E. Chang, A. Exuzides, R. Gandhy, G. Yohrling. Burden of illness among US Medicare beneficiaries with late-onset Huntington’s disease [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/burden-of-illness-among-us-medicare-beneficiaries-with-late-onset-huntingtons-disease/. Accessed May 18, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/burden-of-illness-among-us-medicare-beneficiaries-with-late-onset-huntingtons-disease/