PCV68 ECONOMIC BURDEN OF ATHEROTROMBOTIC DISEASE IN THE CZECH REPUBLIC

Abstract

Atherothrombotic diseases impose a large burden on Czech society, mainly because of the increased prevalence of high-risk patients with several comorbidities. Thus, the aim was to evaluate the direct and indirect costs associated with coronary (CAD) and peripheral artery diseases (PAD) in the Czech Republic. The prevalence of CAD combined with PAD was based on health insurance claims for years 2015-2017 provided by the fifth largest health insurance fund (700,000 insured, i.e. 7 % of the population) and expert opinion. A global Markov model was adopted to predict the number of subsequent cardiovascular events in this population treated with aspirin in secondary prevention. Healthcare costs were based on corresponding reimbursement tariffs. Indirect costs of atherothrombotic disease were calculated based on claims from Czech Social Security Administration (CSSA) database. A total number of 49,215 patients suffering from both CAD and PAD was estimated. In lifetime horizon, these patients will develop 18,766 myocardial infarctions, 7,439 strokes, 6,639 cases of extracranial and 1,525 intracranial haemorrhage, 5,311 cases of acute limb ischaemia, 4,648 amputations, 3,098 cases of venous thromboembolism and 22,292 cardiovascular deaths. From a healthcare payer perspective, all these events will be associated with a total cost of €360.7 million. According to CSSA database, CAD or PAD induce 1,946 cases of invalidity per year, corresponding to €7.4 million of invalidity pensions annually and €24.7 million loss of productivity/year. Moreover, CAD or PAD lead to 4,802 sick-leaves each year, corresponding to annual productivity loss of €55.5 million. In sum, these indirect costs equal to €87.6 million per year. The costs associated with atherothrombotic diseases are substantial. To our knowledge, this is the first Czech study evaluating the burden of atherothrombotic diseases from societal perspective. Our estimates may support future health policy decisions concerning various prevention and intervention programs.