BACKGROUND: Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS: We analyzed data on 1056 patients with symptomatic HF seen at Duke University between 2002 and 2006. Health care costs were obtained from the hospital cost accounting data system. Adjustments for censoring and covariate imbalance were performed using inverse probability weighted estimators and propensity scores. The prevalence of anemia was 32%. Unadjusted mortality at 3 years was 50.3% in anemic versus 26.5% in non-anemic patients. The adjusted costs per year alive were $22,926 for patients with anemia and $17,189 for those without (P=.04). For those with ejection fraction <or=40% adjusted costs per year alive were $32,914 for anemic versus $18,423 for non-anemic patients (P=.01). CONCLUSIONS: Anemia in HF patients was independently associated with greater total costs after accounting for differences in survival, but appeared to be confined primarily to patients with low ejection fraction. These results provide a framework for understanding the economic implications of therapies for anemia in heart failure, and suggest that targeting patients with impaired systolic function has the potential to most favorably affect costs.
BACKGROUND:Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS: We analyzed data on 1056 patients with symptomatic HF seen at Duke University between 2002 and 2006. Health care costs were obtained from the hospital cost accounting data system. Adjustments for censoring and covariate imbalance were performed using inverse probability weighted estimators and propensity scores. The prevalence of anemia was 32%. Unadjusted mortality at 3 years was 50.3% in anemic versus 26.5% in non-anemicpatients. The adjusted costs per year alive were $22,926 for patients with anemia and $17,189 for those without (P=.04). For those with ejection fraction <or=40% adjusted costs per year alive were $32,914 for anemic versus $18,423 for non-anemicpatients (P=.01). CONCLUSIONS:Anemia in HF patients was independently associated with greater total costs after accounting for differences in survival, but appeared to be confined primarily to patients with low ejection fraction. These results provide a framework for understanding the economic implications of therapies for anemia in heart failure, and suggest that targeting patients with impaired systolic function has the potential to most favorably affect costs.
Authors: Tamara B Horwich; Gregg C Fonarow; Michele A Hamilton; W Robb MacLellan; Jeff Borenstein Journal: J Am Coll Cardiol Date: 2002-06-05 Impact factor: 24.094
Authors: A Al-Ahmad; W M Rand; G Manjunath; M A Konstam; D N Salem; A S Levey; M J Sarnak Journal: J Am Coll Cardiol Date: 2001-10 Impact factor: 24.094
Authors: Donna M Mancini; Stuart D Katz; Chim C Lang; John LaManca; Alhakam Hudaihed; Ana-Silvia Androne Journal: Circulation Date: 2003-01-21 Impact factor: 29.690
Authors: G Michael Felker; Wendy A Gattis; Jeffrey D Leimberger; Kirkwood F Adams; Michael S Cuffe; Mihai Gheorghiade; Christopher M O'Connor Journal: Am J Cardiol Date: 2003-09-01 Impact factor: 2.778
Authors: Abel Makubi; Camilla Hage; Johnson Lwakatare; Bruno Mmbando; Peter Kisenge; Lars H Lund; Lars Rydén; Julie Makani Journal: Heart Date: 2014-12-24 Impact factor: 5.994
Authors: Shelby D Reed; Yanhong Li; Stephen J Ellis; John J Isitt; Sunfa Cheng; Kevin A Schulman; David J Whellan Journal: J Card Fail Date: 2012-10 Impact factor: 5.712
Authors: Gina Nicholson; Shravanthi R Gandra; Ronald J Halbert; Akshara Richhariya; Robert J Nordyke Journal: Clinicoecon Outcomes Res Date: 2016-09-21