Objective: To assess epidemiology and economic burden of falls and fractures among Huntington’s disease (HD) patients.

Background: The clinical course of HD is characterized by progressive gait dysfunction, resulting in falls and associated balance problems. This is the first study to assess the economic burden of falls and fractures among HD patients.

Methods: A retrospective cohort analysis was conducted using Truven MarketScan Commercial and Medicare pharmacy and medical claims data. All patients with a claim for HD (confirmed by another diagnosis of HD within 6 months) during 1/1/2009 to 12/31/2014 and accidental fall or fracture (index event) on or after the diagnosis of HD were initially selected. Patients had to be age ≥18 years, continuously enrolled in the 6-month pre-index period and throughout the follow-up period after the first fall or fracture. Descriptive statistics were reported on incidence of falls and fractures, resource utilization, and costs of falls and fractures.

Results: A total of 2270 patients were included (45% male). Mean (SD) follow-up period was 1.6 (1.4) years. The mean Charlson Comorbidity Index score was 0.8 (1.4). A total of 458 patients experienced a fall or fracture requiring medical attention. The incidence rate of first fall was 6.6/100 patients/year (95% CI: 5.8, 7.5), fracture was 8.3/100 patients/year (95% CI: 7.4, 9.3), and fall or fracture was 13.2/100 patients/year (95% CI: 12.1, 14.5). Incidence of fall or fracture increased with age, ranging from 8.8/100 patients/year (95% CI: 5.1, 14.1) for patients age <35 years to 14.6/100 patients/year (95% CI: 13.0, 16.3) for patients age ≥55 years. Annualized mean number of hospitalizations for fall/fracture was 0.8 (4.2) per year with a mean length of stay of 6.5 (41.7) days. Annualized total cost of care for treating patients with falls (n=251) and fractures (n=303) was $36,276 ($243,651) and $37,654 ($205,448), respectively, and cost for the combined cohort was $31,357 ($201,490) per patient. Hospitalizations accounted for the majority of the costs (65% among patients with falls/fractures).

Conclusions: The annual incidence and direct economic burden of falls and fractures among patients with HD is substantial. Therapeutic options that improve gait, reduce falls, and prevent injury among HD patients are warranted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/epidemiology-and-economic-burden-of-falls-and-fractures-in-patients-with-huntingtons-disease/