(265) Effect of Antihypertensive Medications on Economic Burden Among Alzheimer’s Disease and Related Dementia (ADRD): ADRD Registry Data linked to Medicaid

Background: : Alzheimer’s disease and related dementias (ADRD) contribute to a growing economic strain on healthcare systems, particularly as the aging population increases. Antihypertensive medications (AHMs), widely prescribed for managing hypertension, have shown potential neuroprotective benefits that may influence cognitive trajectories. However, the broader economic implications of AHM use among ADRD patients, especially those enrolled in Medicaid, a population often facing compounded health and socioeconomic challenges, remain insufficiently studied.

Objective: : • To assess the association between AHM use and healthcare costs among South Carolina Medicaid beneficiaries with ADRD.
• To examine racial/ethnic disparities in healthcare costs within this population.

Methods: : We conducted a cross-sectional analysis using South Carolina Medicaid data linked to the state’s Alzheimer’s Disease Registry from 2005 to 2021. Individuals aged 65 and older diagnosed with ADRD were included. AHM use was identified via Medicaid pharmacy files, including all FDA-approved AHMs except aliskiren due to data limitations. Annual costs for inpatient, outpatient, emergency department, and prescription drugs were adjusted to 2024 U.S. dollars. Generalized linear models with a gamma distribution and log link were applied to estimate cost differences associated with AHM use, adjusting for age, sex, marital status, and urban/rural residence.

Results: : This study included 7,865 ADRD patients, of whom 61.16% used AHMs. AHM use was significantly associated with higher healthcare expenditures across all service categories: 30.94% higher inpatient costs, 31.81% higher outpatient costs, 24.41% higher emergency room costs, and 224.12% higher prescription drug costs (all P < 0.05). Racial and ethnic disparities were evident: compared to non-Hispanic White patients, non-Hispanic Black, Hispanic, and other minority groups incurred higher inpatient, outpatient, and emergency costs (P < 0.05). Interestingly, non-Hispanic Black patients had 11.74% lower drug costs than White patients (P = 0.002).

Conclusions: : Among Medicaid beneficiaries with ADRD in South Carolina, AHM use is associated with significantly increased costs across various healthcare services. Additionally, notable racial and ethnic disparities in expenditures persist, with minority patients facing greater financial burdens, except in prescription drug spending where patterns vary. These findings emphasize the need for targeted, cost-effective interventions to promote equitable care access and reduce structural barriers affecting historically underserved ADRD populations.

Sponsorship:: None.