Costs and healthcare utilisation of patients with heart failure in Spain

BMC Health Serv Res. 2020 Oct 20;20(1):964. doi: 10.1186/s12913-020-05828-9.

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: DAPA-HF; Dapagliflozin; Heart failure; Heart failure cost; Hospitalization; Sacubitril/valsartan.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Drug Costs / statistics & numerical data
  • Female
  • Health Care Costs / statistics & numerical data*
  • Heart Failure / economics*
  • Heart Failure / therapy*
  • Hospitalization / economics
  • Humans
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Spain