Chronic Heart Failure (CHF) In The Czech Republic: Cost-of-Illness Analysis & Disease Burden Based on Ahead Registry Data Mining

• Published in: Value in health Vol. 20; no. 9; p. A610
• Main Authors: Spinar, J, Parenica, J, Klimes, J, Vesela, V, Blahovcova, M, Dostal, F, Vonka, R
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Coronary artery disease; Cost analysis; Data mining; Data processing; Death; Death & dying; Health care expenditures; Heart diseases; Heart failure; Hospitalization; Inpatient care; Morbidity; Mortality; Mortality rates; Socioeconomic factors; Czech Republic
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.1201

OBJECTIVES: In the absence of local real life mortality & morbidity and costs data associated with CHF in the Czech Republic, we aimed to describe CHF socio-economic disease burden (DB) from health care system perspective.This is necessary to be clarified in order to better understand added value of novel therapies. METHODS: We mined data from existing Acute Heart Failure Database (AHEAD). Subgroup of 1274 patients hospitalized in 2 centers in Moravia for acute heart failure (AHF) and afterwards developing CHF that are included in the AHEAD (local registry including patients after AHF hospitalization = index hospitalization), were followed up for 2 years and frequency of hospitalization and their mortality rate were assessed. Six endpoints were determined - AHF re-hospitalization, acute coronary syndrome hospitalization, cardiovascular (CV) hospitalization, non-CV hospitalization, hospitalization for any cause and overall mortality. Patients were classified into 4 groups based on outcome they reached - no death and no hospitalization; death without hospitalization; hospitalization but no death; hospitalization and death. Each hospitalization event was assigned with particular costs based on DRG tariff, just in-patient costs were descried. RESULTS: Czech patients were generally older than patients in RCTs (median age 75.9 years). After 24 months of follow-up, 36 % of patients died and 68.2 % of patients had at least one hospitalization/ died. Average number of hospitalizations was 1.2 (SD 1.6). The average annual CHF in-patient costs are 2.8k USD (77% of costs attributed to CV hospitalization). Based on 1.6% CHF prevalence, there is 5.3% of all direct health care spending in the Czech represented by hospitalization of CHF patients. CONCLUSIONS: Patients in real life are in significantly higher risk of hospitalization and all-cause mortality (by approx. 80 %), compared to RCT population. Overall HF DB in the Czech is notable and compared to published evidence it is greatly underestimated.