Abstract
BackgroundAs a consequence of unfavourable epidemiological trends and the development of disease management, the economic aspects of heart failure (HF) have become more and more important. The costs of treatment (direct costs) appear to be the most frequently addressed topic in the economic research on HF; however, less is known about productivity losses (indirect costs) and the public finance burden attributable to the disease. Therefore, the aim of this study was to estimate the indirect costs and public finance consequences of HF in Poland in the period 2012–2015.MethodsThe study uses a societal perspective and a prevalence-based top-down approach to estimate the following components of HF indirect costs: absenteeism of the sick and their caregivers, presenteeism of the sick, disability, and premature mortality. The human capital method has been chosen to identify the value of productivity losses attributable to HF and the public finance consequences of the disease. Deterministic sensitivity analysis was performed to assess the robustness of the results.ResultsThe total indirect costs of HF in Poland were €871.9 million in 2012, and they increased to €945.3 million in 2015. In the period investigated, these costs accounted for 0.212–0.224% of GDP, an equivalent of 22.63€–24.59€ per capita. Mortality proved to be the main driver of productivity losses, with 59.3–63.4% of the total costs depending on year, followed by presenteeism (21.1–22.5%), disability (11.1–14.2%) and the sick’s absenteeism (3.3–4.0%). The cost of caregivers’ absenteeism was unimportant. The social insurance expenditure for benefits associated with HF accounted for €40.7 million in 2012 and €45.6 million in 2015 (0.56–0.59% expenditure for all diseases). The potential public revenue losses associated with HF were €262.7–€287.9 million. Sensitivity analysis showed that the costs varied by − 12.1% to + 28.8% depending on the model parameter values.ConclusionHF is a substantial burden on the economy and public finance in Poland. By confronting the disease more effectively, the length and quality of life for those affected by HF could be improved, but society as a whole could also benefit from the increased economic output.
Highlights
As a consequence of unfavourable epidemiological trends and the development of disease management, the economic aspects of heart failure (HF) have become more and more important
The production lost due to HF in Poland accounted for approximately 0.22% of Gross domestic product (GDP) throughout the period; this share declined slightly in the years 2013–2014, followed by an increase in 2015
The disease largely affects older citizens who are no longer professionally active, the productivity losses associated with HF in the working population account for 0.22% of GDP, a high share compared to the US estimates discussed above [14, 16]
Summary
As a consequence of unfavourable epidemiological trends and the development of disease management, the economic aspects of heart failure (HF) have become more and more important. According to Spanish estimates, informal caregiving costs constitute 59.1% to 69.8% of total HF costs [13]; an American study reports HF mortality costs of $10.6 billion [14], while a study from Nigeria approximates the work absence costs of 239 HF cases from a tertiary hospital at an equivalent of US$254238, 44.3% of the overall costs [15] These studies give important insights into the knowledge on productivity losses attributable to HF; the burden estimated therein only accounts for selected components of indirect costs such as mortality, caregiving or work absence in separation, and they do not provide a broad view on total losses. Until now, no study has reported on the public finance burden of HF
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