CVB3 Evaluation of the Costs of Coronary Heart Disease in Belgium

OBJECTIVE: To calculate the cost of ischaemic heart disease in Belgium. METHODS: We calculated the cost of acute and follow-up treatment of coronary heart disease in Belgium, taking into account a weighted average of current practice. Costs related to current practice (1996 values) and disease progression were taken from the perspective of the health insurance. Unit costs of ambulatory care were collected through official listings; hospitalisation costs for heart failure were collected from a database of 58 hospitals (ICD codes 410 to 414). Current practice was obtained through review of 240 patient records in primary care, post coronary event, during 6 months and through expert interviews (2 rounds Delphi method). Epidemiological data regarding incidence and distribution of coronary events were obtained via the MONICA WHO study. RESULTS: The results indicate that the acute cost of coronary heart disease is equal to 191,933 Bef (37Bef = 1$) for acute MI, 175,959 Bef for coronary insufficiency, and 159,912 Bef for angina pectoris. Follow-up costs amount to 47,000 Bef per year, of which 13,000 for drugs, statins not included. An existing model has been applied and reviewed according to Belgian risk predictions to estimate the cost-effectiveness of statins. CONCLUSIONS: The study showed that coronary heart disease is not only expensive in the acute stage but even more in the follow-up. There are no large differences between the costs of different coronary events.