The economic cost heterogeneity of patients with heart failure - a retrospective nationwide study

Abstract Background Heart failure (HF) imposes a major economic burden, however the individual management for patients vary potentially leading to large cost heterogeneity. The aim of this study was to investigate the total direct health cost stratified across the spectrum of cost groups. Methods Using Danish nationwide registries from 2012 to 2015 we identified all patients >18 years with a first-time diagnosis of HF. Total health costs were investigated using two perspectives; at index and after 3 years (including index). We investigated the cost of patients in the highest cost group (highest 10%) vs. the lowest cost group (lowest 10%). A multivariable logistic regression was used to identify variables associated with being in the highest cost decile compared to the rest (90%). Results A total of 11,170 patients with HF were included and those in the highest cost decile (n=1,117, 10%) were younger (69 vs. 75 years), more males (43 vs. 34%), and more inpatients (83 vs. 70%) compared to the rest of the patients (n=10,053, 90%). Patients in the highest cost decile (10%) incurred a 30 times higher cost with a mean total health cost in index year of €86,607 compared to €2,893 for patients in lowest cost decile (10%) (Figure 1A). Results were similar for 3 years aggregated (€139,473 vs. €4,086), corresponding to a 34 times higher cost. At index year, variables associated with being in the highest cost decile included young age, male sex, inpatient admittance, renal disease, and several other comorbidities (Figure 1B). Conclusion Among patients with HF a large total direct health cost heterogeneity exists with younger age, inpatient admittance, male sex, and comorbidities being associated with a higher likelihood of belonging to the highest cost group. Acknowledgement/Funding Novartis