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Patient-level costs of major cardiovascular conditions: a review of the international literature

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ABSTRACT

Objective: Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events.

Methods: MEDLINE database was searched electronically for English language studies published during 2007–2012, with cost estimates for CV events of interest – unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values.

Results: Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union.

Conclusion: This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.

No MeSH data available.


Related in: MedlinePlus

Workflow of included studies.Abbreviations: MI, myocardial infarction; CE, cost-effectiveness.
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f1-ceor-8-495: Workflow of included studies.Abbreviations: MI, myocardial infarction; CE, cost-effectiveness.

Mentions: The search identified 1,178 abstracts. Of these abstracts, 252 (21%) abstracts were retrieved for full-text review. The bibliographies of systematic reviews were searched, yielding an additional seven studies, for a total of 259 studies reviewed. Of the 259 studies retrieved, 83 studies were discarded for having an excluded study design (eight studies), indirect costs or population costs only (22 studies), no event cost estimate (33 studies), review articles (twelve studies), and a sample size of <100 patients (eight studies). A total of 176 studies were abstracted after full-text review (Figure 1).


Patient-level costs of major cardiovascular conditions: a review of the international literature
Workflow of included studies.Abbreviations: MI, myocardial infarction; CE, cost-effectiveness.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036826&req=5

f1-ceor-8-495: Workflow of included studies.Abbreviations: MI, myocardial infarction; CE, cost-effectiveness.
Mentions: The search identified 1,178 abstracts. Of these abstracts, 252 (21%) abstracts were retrieved for full-text review. The bibliographies of systematic reviews were searched, yielding an additional seven studies, for a total of 259 studies reviewed. Of the 259 studies retrieved, 83 studies were discarded for having an excluded study design (eight studies), indirect costs or population costs only (22 studies), no event cost estimate (33 studies), review articles (twelve studies), and a sample size of <100 patients (eight studies). A total of 176 studies were abstracted after full-text review (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Objective: Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events.

Methods: MEDLINE database was searched electronically for English language studies published during 2007&ndash;2012, with cost estimates for CV events of interest &ndash; unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values.

Results: Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union.

Conclusion: This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.

No MeSH data available.


Related in: MedlinePlus