Abstract
ObjectivesTo estimate healthcare costs of new cardiovascular (CV) events (myocardial infarction, unstable angina, revascularization, ischemic stroke, transient ischemic attack, heart failure) in patients with hyperlipidemia or prior CV events.MethodsA retrospective population-based cohort study was conducted using Swedish national registers and electronic medical records. Patients with hyperlipidemia or prior CV events were stratified into three cohorts based on CV risk level: history of major cardiovascular disease (CVD), coronary heart disease (CHD) risk-equivalent, and low/unknown risk. Propensity score matching was applied to compare patients with new events to patients without new events for estimation of incremental costs of any event and by event type.ResultsA CV event resulted in increased costs over 3 years of follow-up, with the majority of costs occurring in the 1st year following the event. The mean incremental cost of patients with a history of major CVD (n = 6881) was €8588 during the 1st year following the event. This was similar to that of CHD risk-equivalent patients (n = 3226; €6663) and patients at low/unknown risk (n = 2497; €8346). Ischemic stroke resulted in the highest 1st-year cost for patients with a history of major CVD and CHD risk-equivalent patients (€10,194 and €9823, respectively); transient ischemic attack in the lowest (€3917 and €4140). Incremental costs remained elevated in all cohorts during all three follow-up years, with costs being highest in the major CVD history cohort.ConclusionsHealthcare costs of CV events are substantial and vary considerably by event type. Incremental costs remain elevated for several years after an event.Electronic supplementary materialThe online version of this article (doi:10.1007/s10198-015-0702-0) contains supplementary material, which is available to authorized users.
Highlights
Cardiovascular disease (CVD), with the usual underlying pathology of atherosclerosis, is a major cause of premature death worldwide and a substantial source of disability
A CV event resulted in increased costs over 3 years of follow-up, with the majority of costs occurring in the 1st year following the event
Incremental costs remained elevated in all cohorts during all three follow-up years, with costs being highest in the major cardiovascular disease (CVD) history cohort
Summary
Cardiovascular disease (CVD), with the usual underlying pathology of atherosclerosis, is a major cause of premature death worldwide and a substantial source of disability. There are several recent studies that have examined the costs of CVD-related events, and especially so with a focus on short-term healthcare costs due to CVD-related events [3,4,5,6,7,8,9,10] These studies have not included patients based on a diagnosis of or treatment for hyperlipidemia but instead included patients hospitalized for CV events [3, 10, 11], patients with atherosclerosis [4], hypertension [5], or acute coronary syndrome [6, 7, 12], or used a prevalence-based approach [8, 9]. Estimates of the cost of recurrent and subsequent CV events are limited; previous studies have focused on the first CV event and limited the study cohorts to those without CVD at baseline
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