OBJECTIVES: Management of hereditary angioedema (HAE) consists of on-demand treatment and, for appropriate patients, the addition of long-term prophylaxis (LTP). Given the increasing number of patients receiving non-androgen LTP and limited data on related real-world healthcare costs in the US, we estimated such costs based on a large retrospective insurance claims database

METHODS: Eligible commercially-insured patients from the IQVIA PharMetrics^® Plus Database records (April 2017 to March 2022) had ≥1 claim for non-androgen LTPs (lanadelumab, berotralstat, intravenous [IV] C1 esterase inhibitor [C1INH] and subcutaneous [SC] C1INH), were ≥12 years old at index (i.e., first non-androgen LTP claim), had ≥6 months of continuous enrollment before and ≥3 months following index. Descriptive analyses examined HAE-related healthcare costs (per patient per year [PPPY]) associated with outpatient visits (OP), inpatient admission (IP), emergency department visit (ED), and home healthcare visits (HH).

RESULTS: The analytic cohort consisted of 210 individuals with a mean ± standard deviation (SD) age of 41±14 years, 72% female, and median follow-up of 16 months. The most common non-androgen LTP treatment received was lanadelumab (50%) followed by SC C1INH (34%), IV C1INH (8%), and berotralstat (8%). Mean total HAE-related healthcare costs PPPY were $641,166. Mean HH costs for patients with at least one HH visit (22%) were $207,784. Mean IP costs for patients with at least one IP visit (11%) were $30,061. Among patients with at least one ED visit (33%), mean costs of ED visits were $25,606. Mean OP costs were $3,297 for patients with at least one OP visit (90%).

CONCLUSIONS: While LTP therapies have been shown to reduce HAE attack rates, analyses revealed that HAE-related non-pharmacy resource utilization costs were substantial in the current study. Future insights related to HAE attack management and cost drivers are needed among LTP users.