PCV55 - The cost-of-disease of thromboembolic and hemorrhagic complications associated with atrial fibrillation and its treatment in Turkey: An expert panel approach for estimation of costs

Abstract

To estimate the costs-of-disease and direct cost components of thromboembolic complications associated with AF and the side-effects related with anticoagulant treatment, in Turkish setting. A panel consisting of experts on cardiology, hematology, pulmonology and neurology, held a meeting to discuss the disease management processes of stroke, SE, IC bleeding and EC bleeding. They reviewed the global and local literature and guidelines, and also they discussed the spectrum of local clinical practices that are performed frequently. All cost components, including medications, surgical treatment, hospitalization, out-patient follow-up procedures and rehabilitation services were reviewed. September 2012 local prices for medications and procedures were used as sources. Mid-2012 USD currency rate was used. The cost of SE was estimated as 431 USD/event (70% non-pharmacologic treatment cost). The cost of acute management of stroke was calculated as 2,517 USD, of which 76% was caused by hospital stay. The annual cost of follow-up of stroke patients was 799 USD/year. The source of almost half (48%) of the cost was non-pharmacologic treatment (namely neurologic rehabilitation). The cost of major EC bleeding was 1014 USD/event (48% hospital stay cost) and the cost of minor EC bleeding is 49 USD/event (~100% hospital stay cost). The cost of acute management of IC bleeding was calculated as 6166 USD/event (86% hospital stay cost). The annual cost of follow-up of patients with IC bleeding was 728 USD/year (52% non-pharmacologic treatment cost). The costs of thromboembolic complications in AF patients are quite high. The acute events of stroke or IC bleeding are quite costly, and additional costs continue to happen due to treatment of neurologic disabilities caused by the primary event. Therefore, the economic burden of these thromboembolic events might be well reduced, if the prevention of these events could be prevented in AF patients.