Major Cardiovascular Consequences of Familial Hypercholesterolemia in Poland from the Economic Perspective

• Published in: Journal of health policy & outcomes research no. 2; pp. 10 - 22
• Main Authors: Kamińska, Ewa, Wójcik, Alicja, Młyńczak, Katarzyna, Lis, Joanna, Dąbrowska, Marta, Wójtowicz, Beata, Smolarska, Anna, Gora, Anna, Niewada, Maciej, Golicki, Dominik
• Format: Journal Article
• Language: English
• Published: 18.04.2018
• ISSN: 2299-1247; 2299-1247
• DOI: 10.7365/JHPOR.2017.2.2

Background. Familial hypercholesterolemia (FH) is a genetic disease characterised by high LDL-C level with other lipid fractions levels typically correct. The disease involves the accelerated development of arteriosclerosis and vascular complications, mainly coronary disease. Patients with FH have an increased risk of the acute coronary syndrome (ACS), ischemic stroke (IS) and peripheral artery disease (PAD). Aims. This publication aims to discuss epidemiology and costs associated with three major vascular complications of FH: ACS (including myocardial infarction, MI), IS and PAD. In case of lack of specific data for FH subpopulation, more general data will be discussed. Results. Meta-analysis of six Polish population studies indicated that heterozygous FH morbidity in Poland is approximately 404/100,000 people what corresponds with approximately 150,000 patients. Each year 123 thousand ACS are reported in Poland of what approximately 62% is a MI. In European population FH is diagnosed in approximately 8.3% patients with ACS (in Polish subpopulation – approximately 11.4%). Total hospitalization costs due to ACS among patients with FH in 2016 equaled PLN 108-148 million, of what hospitalization cost due to MI was approximately PLN 67-91 million. Indirect medical costs during first 36 months after MI in patients with FH may be estimated for PLN 128-175 million and indirect costs of MI in patients with FH for PLN 257-684 million. Conclusions. Early screening for familial hypercholesterolemia and efficient hypolipemic treatment are a chance for significant reduction of incidence of discussed vascular complications and their costs within the healthcare system. We were not able to identify any specific cost data for FH subpopulations of IS and PAD patients.