One-Year Costs in Patients With a History of or at Risk for Atherothrombosis in the United States

Background-Atherothrombosis is the underlying cause of cardiovascular, cerebrovascular, and peripheral arterial disease and is the leading cause of death in the industrialized world. The objectives of the present study are ( 1) to examine the annual costs associated with vascular events and interventions that require hospitalization, as well as long-term medication use for the management of associated risk factors, in a US population of outpatients with multiple atherothrombotic risk factors or a history of symptomatic disease and ( 2) to compare costs across patient subgroups defined according to specific arterial bed(s) affected and the number of affected arterial beds. Methods and Results-The international REduction of Atherothrombosis for Continued Health (REACH) Registry enrolled outpatients >= 45 years of age who had established coronary artery, cerebrovascular, or peripheral artery disease or >= 3 atherothrombotic risk factors. Data on risk factors, associated medications, and vascular hospitalizations and interventions were collected. Of the total 68 236-patient REACH cohort, 25 763 were enrolled from US sites. Complete 1-year data were available for 23 974 (93%) of the US patients. Annualized medication costs ranged from $2401 to $3481. Mean annual hospitalization costs per patient were $1344, $2864, $4824, and $8155 for patients with 0 (n = 6145), 1 (n = 14 353), 2 (n = 3106), and 3 (n = 370) affected arterial beds at baseline (P<0.0001 for trend). Among patients with 1 affected arterial bed, mean hospitalization costs were $2999, $2010, and $3911 for patients with coronary artery disease (n = 11 063), cerebrovascular disease (n = 2613), and peripheral arterial disease (n = 677), respectively. Annualized medication costs ranged from $2401 to $3481. Conclusions-These results reveal the high economic burden of atherothrombosis-related clinical events and procedures and the especially high economic burden associated with polyvascular disease. (Circ Cardiovasc Qual Outcomes. 2008; 1: 38-45.)