Heterogeneous Cost Patterns of Episodic Recurrent Vestibular Vertigo in the Medicare Population: A Case-Control Economic Evaluation
David Kayekjian, Sami I. Nassar, Kit N. Simpson, Jada M. Johnson, Habib G. RizkObjective
To evaluate Medicare costs and healthcare usage with total annual payments comprising hospital, outpatient and prescription costs, neuroimaging, and vestibular and audiometric testing for benign paroxysmal vertigo (BPPV), Ménière’s Disease (MD), and Vestibular Migraine (VM).
Methods
A case-control economic evaluation was conducted using 2018 MarketScan Medicare Database claims. Cohorts included BPPV, MD, and VM Medicare patients matched to controls without dizziness diagnoses by age, sex, state, and Charlson Comorbidity Index. Twelve–month direct medical costs were analyzed.
Results
6049 BPPV patients compared to 6049 controls, 1665 MD patients compared to 3307 controls, and 227 VM patients compared to 451 controls were included. Mean age was similar across groups and ranged from 72.3
Conclusion
Heterogenous Medicare cost patterns were found among the three most common episodic vertigo causes that deviate from the expected pattern in younger counterparts. Medicare VM patients had higher costs than non-VM counterparts while BPPV and MD patients had lower costs with respective controls. Better hands-on education regarding vestibular disorders for “frontline” medical personnel may improve underdiagnosis or misdiagnosis and reduce excessive investigations, creating opportunities for economic burden reduction.