# Retrospective Analysis of Burden of Illness of Congenital Pulmonary Valve Disease in a Large, Commercially Insured US Population

## TL;DR

This study shows that babies born with congenital pulmonary valve disease face high medical costs and hospital stays from early life through age 65.

## Contribution

The study quantifies the lifetime healthcare burden and costs of congenital pulmonary valve disease in a large US population.

## Key findings

- Patients with CPVD had an average of 1.8 inpatient admissions in their first year, with high associated costs.
- Projected cumulative CPVD-related medical costs reached $2.1 million by age 65.
- Over half of patients had nearly 2 months of hospital stays in their first year.

## Abstract

Babies born with congenital pulmonary valve disease (CPVD) face a lifetime burden of disease and significant medical expense beginning in their first year of life.

To assess costs and burden of care in patients with CPVD from birth through age 65.

This retrospective study used administrative claims data to examine healthcare costs and utilization among commercially insured patients with ≥2 claims with CPVD diagnosis between January 1, 2006, and April 30, 2024; the earliest CPVD claim defined the index date. Per-patient-per-year costs were calculated by age category. Mean annual costs for each age group were multiplied by age category duration to estimate full age category period costs. Costs for each age category period were summed to estimate lifetime costs through 65 years of age. Sensitivity analyses were conducted in subgroups with continuous eligibility from birth through 60 months and 120 months.

Among eligible patients (N = 22 751), 53.2% experienced an average of 1.8 CPVD-related inpatient admissions during their first year: mean (standard deviation) cumulative admission days, 50.2 (74.2); with 267 945(737 565;median,6487[interquartilerange(IQR),0−238 486]inassociatedcosts.AmongthosewithinpatientadmissionsforCPVD−relatedproceduresduringchildhood,averageannualcostsrangedfrom97 791 (288 606; 32 029 [15 984-72 762]) to 514 395(926 572;222 373[114 107−530 671]byagecategory.Emergencydepartmentutilizationrangedbetween859 537 (111 982; 13 690 [918-66 625]) and 120 months (N = 174) at 28 893(69 019;2852[400−23 858]).Byage21,projectedcumulativeCPVD−relatedmedicalcostsaveraged788 188 and reached $2.1 million through age 65. Over half of patients had nearly 2 months of hospital stays in their first year, with substantial inpatient costs. The financial burden and demanding care began early and remained steady, reflecting the chronic nature of CPVD.

This study demonstrates a substantial burden of illness and lifetime mosaic of ongoing medical needs for individuals with CPVD and the potential for advances in early life care to reduce this sizable projected lifetime burden.