Annual health care costs among Medicare Beneficiaries with essential tremor

  • Kandice A. Kapinos
    Corresponding author. Department of Population & Data Sciences Department of Internal Medicine University of Texas Southwestern Medical Center 5323 Harry Hines Blvd., Dallas, TX, USA.
    Peter J. O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA

    RAND Corporation, Arlington, VA, USA
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  • Elan D. Louis
    Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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      • There are no published data on the medical costs associated with ET care.
      • Understanding the associated medical costs will help policymakers and researchers.
      • We estimate the average direct medical expenditures attributable to ET.
      • ET beneficiaries have $1068 more annual expenditures relative to comparisons.
      • This aggregates to $1.5 billion to $5.4 billion in additional annual costs for ET.



      Essential tremor (ET) is one of the most common neurological disorders, affecting an estimated 2.2% of the entire US population. Despite its high prevalence and associated morbidity and mortality, there are no published data on the medical costs associated with ET care.


      This is a retrospective secondary data analysis using the 5% Medicare claims data from 2016 to study age-eligible Medicare beneficiaries diagnosed with ET (diagnostic code G250) relative to a propensity score-matched group of comparison beneficiaries without ET (27,081 in each arm). Comparisons were matched within age strata and on the full set of Charlson comorbidity indicators, race, and sex. We examined encounter-level costs (amounts paid) and total annual costs of care (in constant $2021 dollars) adjusting for age, sex, race/ethnicity, provider specialty, setting, and the most common comorbidities, using a generalized linear model.


      The final sample included 54,162 total beneficiaries, with an average age of 75, 65% female and 94% Non-Hispanic White. On average, Medicare beneficiaries with at least one outpatient or physician office visit with an ET diagnosis have $1068 (95% CI: $981, $1154) in additional direct medical care expenditures per year relative to statistically similar comparison beneficiaries of the same age. Across the population, we predicted aggregated additional spending attributable to ET among Medicare beneficiaries between $1.5 billion and $5.4 billion per year.


      The estimated direct medical costs among Medicare beneficiaries with an ET diagnosis aggregated to the population-level are non-trivial. These data begin to fill a gap in knowledge.
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