The cost-of-illness due to rheumatic heart disease: national estimates for Fiji.

Background: Rheumatic heart disease (RHD) is a chronic valvular heart disease that is responsible for a heavy burden of premature mortality in Low- and middle-income countries. The total costs of RHD are important to health policy and research investment decisions. We estimate for the first time the total cost of RHD for Fiji (2008-2012) using a cost-of-illness approach and novel primary data on RHD disease burden and costs. Methods: RHD cases were identified using probabilistic record Linkage across four routine data sources: (1) the Fiji RHD Control Program, (2) national hospital admissions records, (3) the Ministry of Health database of cause-specific deaths and (4) hospital ECG clinic registers. For each individual with RHD, we obtained information on RHD hospital admissions, treatment and death. We conducted a prevalence-based cost-of-illness analysis, including bottom-up assessment of indirect and direct (healthcare) costs. Results: The estimated cost of RHD in Fiji for 2008-2012 was year-2010 $FJ91.6 million (approximately US$47.7 million). Productivity Losses from premature mortality constituted the majority of costs (71.4%). Indirect costs were 27-fold Larger than the direct costs. Conclusions: RHD Leads to a heavy economic burden in Fiji. Improved prevention strategies for RHD will Likely confer substantial economic benefits to the country.