Examine healthcare resource utilization (HRU) and costs among US Medicare beneficiaries with late-onset Huntington’s disease (LoHD).

Limited evidence exists for the burden of illness in LoHD.

This was a retrospective longitudinal cohort study using 2008-2017 Medicare Research Identifiable Files (100%). We identified Medicare beneficiaries with newly diagnosed LoHD, defined as having ≥1 medical claim with a HD diagnosis (ICD-9-CM: 333.4; ICD-10-CM: G10) between 2009 and 2014, aged ≥60 years at first HD diagnosis (index date) and no HD claims for 1 year pre-index. Beneficiaries without HD (controls) were identified using a 5% random sample of Medicare beneficiaries and matched 1:1 (age, sex, geographic region, index year) to patients with LoHD. All beneficiaries had continuous enrollment in Medicare fee-for-service for 1 year pre- and 3 years post-index. All-cause HRU and costs (2017 US dollars) were measured over 3 years post-index and compared using chi-square (categorical variables) and t-tests (continuous variables).

2,652 beneficiaries were included (LoHD, n=1,326; controls, n=1,326). Mean (standard deviation [SD]) age was 74.7 [7.4] years, and 64.4% of beneficiaries were female. LoHD beneficiaries had higher mean [SD] Charlson Comorbidity Index (2.5 [2.6] vs. 1.9 [2.2]) and prevalence of anxiety (22.8% vs. 12.2%), dementia (12.3% vs. 2.9%) and depression (6.9% vs. 2.6%) compared with controls. At Year 1 post-index, LoHD beneficiaries had significantly higher utilization of: antidepressants (45.9% vs. 25.3%), anxiolytics (12.7% vs. 8.4%), hospitalizations (31.9% vs. 15.9%), emergency department visits (36.1% vs. 22.8%), and higher total costs ($28,863 [$36,937] vs. $13,923 [$24,146]) compared with controls, driven by higher outpatient costs ($12,285 [$14,299] vs. $6,796 [$9,720]); all p<0.001. At Years 2–3 post-index, HRU and costs remained significantly higher among LoHD beneficiaries compared with controls.