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A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

Author

Listed:
  • Michael Urbich

    (Amgen (Europe) GmbH, Global Health Economics)

  • Gary Globe

    (Amgen Inc, Global Health Economics)

  • Krystallia Pantiri

    (Pharmerit – an OPEN Health Company)

  • Marieke Heisen

    (Pharmerit – an OPEN Health Company)

  • Craig Bennison

    (Pharmerit – an OPEN Health Company)

  • Heidi S. Wirtz

    (Amgen Inc, Global Health Economics)

  • Gian Luca Di Tanna

    (University of New South Wales)

Abstract

Background Heart failure presents a growing clinical and economic burden in the USA. Robust cost data on the burden of illness are critical to inform economic evaluations of new therapeutic interventions. Objectives This systematic literature review of heart failure-related costs in the USA aimed to assess the quality of the published evidence and provide a narrative synthesis of current data. Methods Four electronic databases (MEDLINE, EMBASE, EconLit, and the Centre for Reviews and Dissemination York Database, including the NHS Economic Evaluation Database and Health Technology Assessment Database) were searched for journal articles published between January 2014 and March 2020. The review, registered with PROSPERO (CRD42019134201), was restricted to cost-of-illness studies in adults with heart failure events in the USA. Results Eighty-seven studies were included, 41 of which allowed a comparison of cost estimates across studies. The annual median total medical costs for heart failure care were estimated at $24,383 per patient, with heart failure-specific hospitalizations driving costs (median $15,879 per patient). Analyses of subgroups revealed that heart failure-related costs are highly sensitive to individual patient characteristics (such as the presence of comorbidities and age) with large variations even within a subgroup. Additionally, differences in study design and a lack of standardized reporting limited the ability to compare cost estimates. The finding that costs are higher for patients with heart failure with reduced ejection fraction compared with patients with preserved ejection fraction highlights the need for differentiating among different heart failure types. Conclusions The review underpins the conclusion drawn in earlier reviews, namely that hospitalization costs are the key driver of heart failure-related costs. Analyses of subgroups provide a clearer understanding of sources of heterogeneity in cost data. While current cost estimates provide useful indications of economic burden, understanding the nuances of the data is critical to support its application.

Suggested Citation

  • Michael Urbich & Gary Globe & Krystallia Pantiri & Marieke Heisen & Craig Bennison & Heidi S. Wirtz & Gian Luca Di Tanna, 2020. "A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)," PharmacoEconomics, Springer, vol. 38(11), pages 1219-1236, November.
    • Handle: RePEc:spr:pharme:v:38:y:2020:i:11:d:10.1007_s40273-020-00952-0
    DOI: 10.1007/s40273-020-00952-0
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    1. Ajay Agrawal & Joshua S. Gans & Avi Goldfarb, 2023. "Similarities and Differences in the Adoption of General Purpose Technologies," NBER Chapters, in: Technology, Productivity, and Economic Growth, National Bureau of Economic Research, Inc.
    2. Alfredo Palacios & Carlos Rojas-Roque & Lucas González & Ariel Bardach & Agustín Ciapponi & Claudia Peckaitis & Andres Pichon-Riviere & Federico Augustovski, 2021. "Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review," PharmacoEconomics, Springer, vol. 39(5), pages 485-502, May.

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