Herzinsuffizienz nach Myokardinfarkt in Deutschland — Ökonomische Bedeutung und Einschränkung der Lebensqualität

Abstract

Heart failure is a frequent cause of morbidity and mortality (particularly post myocardial infarction) and has been moved into the focus of public health care in the last few years. Apart from patho-physiological, clinical, and epidemiological research questions, health economic aspects are increasingly becoming more important. The present model determines the epidemiological and health economic disease burden of post myocardial infarction heart failure in Germany. Basis for the analysis was a literature review of relevant publications since 1990. The incidence of post myocardial infarction heart failure was estimated for two scenarios and, using a Markov model, the course of the disease and the associated use of resources over a period of nine years was calculated. Subsequently, the annual cost of all prevalent cases was determined. The calculation of the incidence in Germany varies between 50,000 (best case scenario) and 90,000 (worst case scenario) per year. These patients cause total costs of € 1.4–2.5 billion during the selected observation period (direct costs account for approx. 55 %). The prevalence per year is estimated to be 250,000 to 450,000. These patients cause a financial burden of approximately € 0.9–1.6 billion per year. The majority is due to hospital treatment (€ 0.3–0.5 billion) and the loss of productivity due to premature mortality (€ 0.2–0.4 billion). Apart from the monetary consequences, it has to be assumed that heart failure reduces the quality of life for these patients by about 50 % compared to that of the normal population at a comparable age. In light of the heavy financial burden in particular due to hospital treatment and loss of productivity associated with the manifestation of heart failure, an early and effective therapy of the initial myocardial infarction (e. g. by adequate lysis or PTCA therapy) is essential. If heart failure nevertheless develops after myocardial infarction, best possible secondary prevention strategies are necessary.