Economic Burden of Heart Failure in??the Elderly

Abstract

Heart failure (HF) ranks among the most costly chronic diseases in developed countries. At present these countries devote 1-2% of all healthcare expenditures towards HF. In the US, these costs are estimated at $US30.2 billion for 2007. The burden of HF is greatest among the elderly, with 80% of HF hospitalizations and 90% of HF-related deaths in this cohort. As a result, approximately three-quarters of the resources for HF care are consumed by elderly patients. As demographic shifts increase the number of elderly individuals in both developed and developing nations, the resources devoted to HF care will likely further increase. Hospitalization accounts for roughly two-thirds of HF costs, but procedures, outpatient visits and medications also consume significant financial resources. HF also adversely impacts patient quality of life, and these relevant effects may not be captured in pure cost analyses. The cost effectiveness of several pharmacological interventions has been explored. In general, neurohormonal antagonists used for outpatient treatment of chronic HF are relatively cost effective, in part by reducing hospitalizations. Because HF poses such an enormous financial burden, efficient resource allocation for its management is a major societal and governmental challenge. In order to make informed decisions and allocate resources for HF care rationally, detailed data regarding costs and resource use will be essential. Further studies are needed to examine the impact of pharmacological and non-pharmacological interventions on costs and resource use in elderly individuals with HF.

Telemonitoring for Seniors with Chronic Heart Failure: Patient Self-Care, Empowerment, and Adoption Factors

“…More than 5.8 million people in the United States (US) and 23 million people worldwide suffer from HF [4], and the prevalence of this condition is high among elderly who usually account for 80% of hospitalizations and 90% of HF-related deaths [20]. In general, HF is responsible for one out of eight deaths in the US [4], and it represents a significant economic burden in developed countries, often accounting for 1% to 2% of healthcare expenditures [20].…”

Digoxin Is Not a Substrate for Organic Anion-Transporting Polypeptide Transporters OATP1A2, OATP1B1, OATP1B3, and OATP2B1 but Is a Substrate for a Sodium-Dependent Transporter Expressed in HEK293 Cells

“…Over the past decade, the incidences of chronic heart failure have continued to increase, and approximately 5 million people in the United States are now affected by this disease (Klein et al, 2003;Liao et al, 2008). Digoxin, a cardiac glycoside drug, is commonly used for treatment of chronic heart failure and atrial fibrillation (Hunt et al, 2005) and is frequently prescribed to patients who are also taking diuretics, angiotensin-converting enzyme inhibitors, and ␤-blockers (Hunt et al, 2005).…”

Cardiac neuronal imaging with 123I-meta-iodobenzylguanidine in heart failure: implications of endpoint selection and quantitative analysis on clinical decisions

“…HF is the leading cause of hospitalization in the US and Europe, resulting in over 1 million admissions as a primary diagnosis and representing 1 to 2 % of all hospitalizations; moreover, in the last decade, the early postdischarge mortality and readmission rates have remained largely unchanged and may even be worsening [12]. There are now over 1 million HF hospitalizations annually in the US alone and approximately 70 % of total direct costs are attributable to inpatient care [13]. Also if HF hospitalization is not to be considered a "surrogate endpoint" and certainly represents a "hard" event, it is associated with its own limitations [14].…”