Clinical and economic burden among older adults with acromegaly in the United States

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Abstract
Aim: To compare healthcare resource utilization (HCRU) and costs between older adults with and without acromegaly. Materials & methods: Using 2017–2022 100% Medicare Research Identifiable Files, we identified beneficiaries (≥65 years) with prevalent cases of acromegaly. A randomly selected claim with an acromegaly diagnosis was the index date. Beneficiaries were required to have continuous enrollment in Medicare fee-for-service and Part D for the 1-year post-index period (observation period). Beneficiaries with acromegaly were matched 1:1 (age, sex, race, US geographic region) to acromegaly-free beneficiaries (reference group). The beneficiaries in the reference group were assigned the same index date as their matched beneficiary with acromegaly and met the same enrollment criteria. Outcomes of interest, measured during the observation period, included all-cause and acromegaly-related HCRU and costs (adjusted to 2022 US dollars). Results: We identified 3491 beneficiaries with acromegaly and 3491 without acromegaly. The mean age was 73.1 years and the majority of beneficiaries were female and non-Hispanic White. Beneficiaries with acromegaly had more HCRU than those without acromegaly, including a greater proportion with hospitalizations (27.6 vs 14.9%), ED visits (31.8 vs 22.8%), use of skilled nursing facility care (7.3 vs 3.5%) and home health agency visits (18.1 vs 8.4%) (p < 0.001 for all). Total all-cause healthcare costs were higher among beneficiaries with acromegaly versus those without acromegaly ($45,830 vs $18,922, p < 0.001). The majority of beneficiaries with acromegaly (69.6%) did not have evidence of acromegaly treatment. Conclusion: Medicare beneficiaries with acromegaly have substantial HCRU and costs compared with controls without acromegaly; this indicates a high burden of illness which may be lessened by new and effective therapeutic options for those with acromegaly.

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