Hypoparathyroidism: clinical profiles, healthcare use, and costs from real-world data from Italy.

Aim: To describe the epidemiological, clinical, and healthcare profiles of treated hypoparathyroidism in Italy and to evaluate healthcare resource utilization and direct costs. Methods: Patients with hypoparathyroidism between 2016 and 2022 were identified from the ReS administrative database (∼5.5 million Italian citizens of various regions) through an algorithm based on exemption codes, pharmaceutical consumption, hospital diagnosis/procedures, and emergency department (ED) access. The disease prevalence was determined. Demography, clinical characteristics, 1-year healthcare resource utilization (pharmaceuticals, hospitalizations, ED accesses, and outpatient services), and direct costs were analyzed for the cohort of treated patients and for a sub-cohort with higher treatment intensity (HTI) (i.e. with high-dose of calcium/calcitriol). Results: Hypoparathyroidism's annual prevalence ranged from 25.5 to 27.6 per 100,000, with a higher prevalence among middle-aged females. The treated patient cohort (n = 2,791) and the sub-cohort with HTI (n = 662) were identified. Among treated patients, 75.2% had at least one comorbidity and 22.2% had three or more; these percentages were higher in the sub-cohort. A widespread consumption of calcium and/or vitamin D was observed in both cohorts, whereas other treatments were scarcely used. Hospitalization and ED access rates were 24.2 and 24.7%, respectively, for the main cohort and 37.8 and 32.5%, respectively, for the sub-cohort. Mean annual per-patient costs were €2,885 for the main cohort and €3,791 for the sub-cohort. Conclusion: Hypoparathyroidism, due to its chronicity and complex comorbidity profile, represents a substantial and long-term source of healthcare expenditure. These findings highlight an unmet need, particularly for HTI patients, requiring more specific therapies to improve outcomes.