Costs and healthcare utilisation of patients with heart failure in Spain
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(2020) 20:964
RESEARCH ARTICLE
Open Access
Costs and healthcare utilisation of patients with heart failure in Spain Carlos Escobar1* , Luis Varela2, Beatriz Palacios2, Margarita Capel2, Antoni Sicras3, Aram Sicras3, Antonio Hormigo4, Roberto Alcázar5, Nicolás Manito6 and Manuel Botana7
Abstract Background: Increasing the knowledge about heart failure (HF) costs and their determinants is important to ascertain how HF management can be optimized, leading to a significant decrease of HF costs. This study evaluated the cumulative costs and healthcare utilisation in HF patients in Spain. Methods: Observational, retrospective, population-based study using BIG-PAC database, which included data from specialized and primary care of people ≥18 years, from seven autonomous communities in Spain, who received care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until 2019. Results: We identified 17,163 patients with HF (year 2015: mean age 77.3 ± 11.8 years, 53.5% men, 51.7% systolic HF, 43.6% on NYHA functional class II). During the 2015–2019 period, total HF associated costs reached 15,373 Euros per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a progressive decrease of cardiovascular disease hospital costs per year (from 2834 Euros in 2015 to 2146 Euros in 2019, P < 0.001), as well as cardiovascular and diabetic medication costs. Conclusions: During the 2015–2019 period, costs of HF patients in Spain were substantial, being HF hospitalizations the most important determinant. Medication costs represented only a small proportion of total costs. Improving HF management, particularly through the use of drugs that reduce HF hospitalization may be helpful to reduce HF burden. Keywords: Heart failure cost, Dapagliflozin, DAPA-HF, Heart failure, Hospitalization, Sacubitril/valsartan
Background Heart Failure (HF) is a complex clinical syndrome caused by structural or functional cardiac alterations, leading to a reduced cardiac output or elevated intracardiac pressures at rest or during stress, that cause the typical symptoms such as breathlessness, or fatigue [1, 2]. HF is a growing problem worldwide [3]. It has been estimated that the prevalence of HF is around 2% of the adult population in developed countries, raising to more than 10% in those * Correspondence: [email protected] 1 University Hospital La Paz, Madrid, Spain Full list of author information is available at the end of the article
individuals aged 70 years or older [4]. In Spain, it has been reported a higher prevalence of HF, reaching 5% in some studies [5, 6]. Of note, it is expected that the prevalence of HF will increase in the following years, mainly due to the ageing of the population, the rise in HF risk factors (i.e. hypertension, diabetes)
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