PCV68 - The Economic Burden of Four Heart Conditions in Brazil

Abstract

The economic burden of heart conditions in Brazil has not been previously quantified. This study assessed the economic burden of heart failure (HF), myocardial infarction (MI), atrial fibrillation (AF), and hypertension (HTN) in Brazil, and the cost effectiveness (CE) of telemedicine (TM) and structured telephone support (STS) for the treatment of HF. To estimate the cost of four heart conditions by country, a prevalence approach was used for HF, AF and HTN, and an incidence approach was used for MI. Costs were estimated for the year 2015 and included health system expenditures, productivity losses (absenteeism, lower workforce participation, premature mortality) and informal care costs, and deadweight losses associated with government expenditures. Data inputs for costs, including prevalence and incidence, were based on secondary data sources informed by a targeted literature review including country specific grey literature and data bases. The study also appraised the value of the loss of healthy life, measured in disability adjusted life years (DALYs), using global burden of disease disability weights. All inputs were triangulated using semi-structured interviews with clinicians, insurers and health administrators. The CE of TM and STS relative to usual care was assessed using a Markov model consisting of two permanent and two temporary health states. Accounting for co-morbidities, the conditions affected approximately 45.7 million people (32% of the adult population) in Brazil in 2015 leading to significant wellbeing loss, estimated at 3.2 million DALYs, and economic burden, estimated at BRL56.2 billion in 2015. The CE analysis suggested that TM and STS may both be cost effective treatment options for the management of patients with HF. Heart conditions impose a significant burden to the health system and society; their prevention and appropriate management would result in substantial wellbeing benefits and economic savings.