Costs of treating cardiovascular events in Germany: a systematic literature review

Abstract

ObjectiveThis study aims to systematically evaluate available evidence regarding direct medical costs of treating cardiovascular (CV) events in Germany after 2003 on an individual patient basis and from a payer perspective. The CV events of interest were myocardial infarction (MI), unstable angina, heart failure (HF), stroke, and peripheral artery disease (PAD).MethodA systematic literature search was performed in the following databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines - Medline, Embase, Centre for Reviews and Dissemination, TIBORDER, and German dissertation database from January 2003 to October 2013. Both observational studies and randomized clinical trials were considered for the review. All values stated in € are inflation adjusted to 2014 € unless stated otherwise.ResultThis review included 13 articles. For newly occurred MI patients, the average hospitalization costs during the acute phase were reported to be between € 6790 and € 8918 per admission. In the first year after a MI event, direct medical costs were € 13,838–14,792 per patient. Direct medical costs of chronic HF patients were found to be between € 3417 and 5576 per patient per year. Treatment costs increase with disease progression. The average treatment costs for hospitalized PAD in the acute phase were reported to be € 4963 per admission, € 2535 per patient during month 1–6 after the initial hospitalization, € 1601 in month 7–12, and € 1390 in month 13–18. For stroke of all types, total direct medical costs in the 1st year after an event were reported to be € 13,273 per patient. Total direct medical costs during the 1st year after an ischemic stroke event were € 17,399–21,954 per patient, € 6260 in month 13–18, and € 6496 per year in the subsequent 4 years.ConclusionMI, unstable angina, HF, stroke and PAD have a high financial impact on the German health care system. Treatment costs of these diseases are mostly incurred during the acute phase of events and tend to decrease over time. Hospitalization and rehabilitation costs were two major cost drivers. Medication costs was one of the smallest cost component reported.

Epidemiology of heart failure in Germany: a retrospective database study

“…The financial burden of HF on healthcare systems is dominated by the direct hospital costs of inpatient stays [ 9 , 11 ], and treatment costs have been shown to increase with disease progression [ 11 ]. In the current study, HF was the most common reason for hospitalization of patients with newly diagnosed HF, and the risk of hospitalization increased with increasing age.…”

“…A recent systematic review found that direct medical costs for patients with chronic HF were €3417–5576 per patient per year. Furthermore, treatment costs were shown to increase with disease progression [ 11 ]. This confirms the high financial impact that HF has on the German healthcare system.…”

Erratum to: ‘Costs of treating cardiovascular events in Germany: a systematic literature review’

“…Unfortunately, the original version of this article [ 1 ] contained an error. The full author list and affiliations was not included.…”

Hospital and Institutionalisation Care Costs after Limb and Visceral Ischaemia Benchmarked Against Stroke: Long-Term Results of a Population Based Cohort Study

“…Although the present study did not compare the care costs following stroke and an ACLVI event with those after myocardial infarction (MI) in OXVASC, previous studies have shown that the care costs of stroke are higher in the long term than those of MI. 21 , 22 , 23 , 24 , 25 Given that costs of CLI are substantially higher than those for overall ACLVI events, this would therefore suggest that CLI is one of the costliest cardiovascular events.…”