Miguel Rebordão de Almeida Gouveia1, Raquel Maria Sousa E Silva Ascenção2, Francesca Fiorentino3, João Nuno Marques Parracho Guerra da Costa4, Paula Maria Broeiro-Gonçalves5, Maria Cândida Faustino Gamito da Fonseca6, Margarida de Fátima Palma Feria Borges7. 1. Catolica Lisbon School of Business and Economics, Universidade Católica Portuguesa, Lisboa, Portugal. 2. Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. 3. Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. Electronic address: cembe@medicina.ulisboa.pt. 4. Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. 5. Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Agrupamento de Centros de Saúde Lisboa Central, Unidade de Cuidados de Saúde Personalizados dos Olivais, Lisboa, Portugal. 6. Clínica de Insuficiência Cardíaca, Serviço de Medicina III e Hospital de Dia Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal. 7. Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Abstract
INTRODUCTION AND OBJECTIVES: Heart failure (HF) is a growing public health problem. This study estimates the current and future costs of HF in mainland Portugal. METHODS: Costs were estimated based on prevalence and from a societal perspective. The annual costs of HF included direct costs (resource consumption) and indirect costs (productivity losses). Estimates were mostly based on data from the Diagnosis-Related Groups database, real-world data from primary care, and the opinions of an expert panel. Costs were estimated for 2014 and, taking population aging into account, changes were forecast up to 2036. RESULTS: Direct costs in 2014 were €299 million (39% for hospitalizations, 24% for medicines, 17% for exams and tests, 16% for consultations, and the rest for other needs, including emergencies and long-term care). Indirect costs were €106 million (16% for absenteeism and 84% for reduced employment). Between 2014 and 2036, due to demographic dynamics, total costs will increase from €405 to €503 million. Per capita costs are estimated to rise by 34%, which is higher than the increase in total costs (+24%), due to the expected reduction in the resident population. CONCLUSIONS: HF currently has a significant economic impact, representing around 2.6% of total public health expenditure, and this is expected to increase in the future. This should be taken into account by health policy makers, alerting them to the need for resource management in order to mitigate the impact of this disease.
INTRODUCTION AND OBJECTIVES:Heart failure (HF) is a growing public health problem. This study estimates the current and future costs of HF in mainland Portugal. METHODS: Costs were estimated based on prevalence and from a societal perspective. The annual costs of HF included direct costs (resource consumption) and indirect costs (productivity losses). Estimates were mostly based on data from the Diagnosis-Related Groups database, real-world data from primary care, and the opinions of an expert panel. Costs were estimated for 2014 and, taking population aging into account, changes were forecast up to 2036. RESULTS: Direct costs in 2014 were €299 million (39% for hospitalizations, 24% for medicines, 17% for exams and tests, 16% for consultations, and the rest for other needs, including emergencies and long-term care). Indirect costs were €106 million (16% for absenteeism and 84% for reduced employment). Between 2014 and 2036, due to demographic dynamics, total costs will increase from €405 to €503 million. Per capita costs are estimated to rise by 34%, which is higher than the increase in total costs (+24%), due to the expected reduction in the resident population. CONCLUSIONS:HF currently has a significant economic impact, representing around 2.6% of total public health expenditure, and this is expected to increase in the future. This should be taken into account by health policy makers, alerting them to the need for resource management in order to mitigate the impact of this disease.
Keywords:
Cost of illness; Custo da doença; Custos de cuidados de saúde; Custos diretos; Custos indiretos; Direct costs; Forecasting; Health care costs; Heart failure; Indirect costs; Insuficiência cardíaca; Previsões