Societal and economic burden of dilated cardiomyopathy

Abstract

Abstract Background/Introduction Dilated cardiomyopathy (DCM) is a major cause of heart failure and can be associated with events like arrhythmias, syncope or sudden cardiac death. Next to the physical disease burden and the mental strain for patients, DCM also poses a substantial economic burden on society; however, respective data is missing. Purpose This study aims to measure the quality of life (QoL) and societal costs of DCM patients. Methods A cross-sectional evaluation of QoL and societal costs of DCM patients was performed through the 5-level EuroQol (EQ-5D-5L) and the Medical Consumption Questionnaire (iMCQ) and Productivity Cost Questionnaire (iPCQ), respectively. QoL was translated into numerical values (i.e. utilities) for statistical analysis. Costs were measured from a Dutch societal perspective including medical costs, patient and family costs, productivity losses and costs in other sectors. Final costs were extrapolated to one year, reported in 2022 Euros, and compared between DCM severity according to NYHA classes. Results A total of 550 DCM patients were included. Mean age was 61 years, and 34% were women. Among EQ-5D dimensions, DCM patients scored lowest in usual activities, pain/discomfort and mobility (Figure 1). Overall utility was lower than the Dutch population mean (0.840 vs. 0.869, p = .225). Total societal DCM costs were €14,843 per patient per year (Figure 2). Cost drivers were productivity losses (€7,037) and medical costs (€4,621) due to inpatient care (€2,231), outpatient care (€863) and medication (€805). Patients with more symptomatic DCM (i.e. NYHA class III or IV) had significantly higher average DCM costs per year compared to less symptomatic DCM (€31,099 vs. €11,446, p < .001) and significantly lower utilities (0.631 vs. 0.883, p < .001). Conclusion DCM is associated with reduced QoL and high societal costs, especially in more advanced disease stages. To our knowledge, this is the first study describing the economic burden of DCM in the Netherlands. More studies in DCM are needed to confirm these results.Quality of life of DCM patientsTotal DCM costs per patient per year