Health care resource utilization and costs associated with obesity classes among patients with heart failure with preserved ejection fraction

Introduction: Obesity-related HFpEF is linked to worse quality of life and health outcomes; however, the association of obesity with real-world healthcare resource utilization (HCRU) and economic burden in HFpEF is unknown. This study assessed the association between BMI and HCRU- and cost-related outcomes among patients with HFpEF. Methods: This claims-based study utilized the Optum Market Clarity database to identify adult commercial, Medicare, and Medicaid patients with HFpEF based on EF ≥ 50% and ≥ 1 diagnosis of HF from Oct 01, 2016 to Mar 31, 2023. Baseline clinical characteristics, post-index rehospitalization rates, and per-patient-per-year HCRU and cost data were described. Associations between BMI and HCRU and cost outcomes was examined using generalized linear models adjusted for baseline characteristics. Results: A total of 95,070 patients were included; 14.4% were with normal weight, 26.1% with overweight, 23.8% Class 1 obesity, 15.9% Class 2 obesity, and 19.9% Class 3 obesity. Across cohorts, patients with Class 2 and Class 3 obesity had high rates of all-cause and HF-related rehospitalizations. Patients with Class 2 and Class 3 obesity had higher rates of HF-related hospitalization/ER visits (both p < 0.001), compared to the overweight cohort, when adjusted for baseline covariates. Across comparisons, patients with Class 3 obesity had numerically higher HF-related costs compared with the overweight cohort. Conclusions: This study demonstrated that patients with HFpEF and Class 3 obesity incurred higher healthcare costs, more frequent all-cause and HF-related acute care encounters, in general, and increased readmissions rates, compared to patients in other BMI groups.