Abstract
Heart Failure (HF) is the end-stage of multiple cardiovascular diseases with a five-year survival rate of less than 50%. In China, very few studies on HF treatment pattern and associated costs have been done to understand HF patients’ disease burden and unmet medical needs. This study aims to utilize the latest national claim data to investigate HF treatment management and costs in Chinese patient population and compare that with earlier years. Adult patients with ≥1 heart failure diagnosis identified by ICD10 code (I50.0, I50.1, and I50.9) or HF-related diagnosis in Jan 2017 were identified and full-year in/outpatient claims were retrieved from national claim database administered by Chinese Health Insurance Research Association. Annual treatment costs breakdown, HF drug costs,prescribing patterns and frequency of hospital visits were assessed. A total of 2,931 HF patients with one-year consecutive records were identified. 46.6% were women and the mean age was 72.1 (74.5% ≥ 65 years). The mean annual treatment cost per HF patient was 32,215 RMB. 68% patients were hospitalized within the year with annual inpatient cost of 34,329 RMB, and each hospitalization cost was 10,814 RMB. 32% and 45% patients were treated with first-line HF therapy ACEI and ARB with annual costs of 457 RMB and 815 RMB. 27% patients were prescribed combination therapies (ACEI/ARB+β-blocker+MRA). Patients on average had total 36 HF-related hospital visits per year and three of which were inpatient visits. 30-day readmission rate was 38.9%, and 1-year readmission was 60.8%。 HF treatment cost had increased by 15% from 2014-2017, and hospitalization is the most dominant cost driver. The HF drug utilization rate suggested guideline adherence of SoC was suboptimal. The study showed significant disease economic burden to HF patients and thus strong unmet medical need to reduce HF hospitalization and improve guideline adherence in China.
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