Humanistic burden and economic impact of heart failure – a systematic review of the literature

Abstract

Background: Heart failure (HF) is increasing in prevalence worldwide. This systematic review was conducted to inform understanding of its humanistic and economic burden. Methods: Electronic databases (Embase, MEDLINE®, and Cochrane Library) were searched in May 2017. Data were extracted from studies reporting health-related quality of life (HRQoL) in 200 patients or more (published 2007–2017), or costs and resource use in 100 patients or more (published 2012–2017). Relevant HRQoL studies were those that used the 12- or 36-item Short-Form Health Surveys, EuroQol Group 5-dimensions measure of health status, Minnesota Living with Heart Failure Questionnaire or Kansas City Cardiomyopathy Questionnaire. Results: In total, 124 studies were identified: 54 for HRQoL and 71 for costs and resource use (Europe: 25/15; North America: 24/50; rest of world/multinational: 5/6). Overall, individuals with HF reported worse HRQoL than the general population and patients with other chronic diseases. Some evidence identified supports a correlation between increasing disease severity and worse HRQoL. Patients with HF incurred higher costs and resource use than the general population and patients with other chronic conditions. Inpatient care and hospitalizations were identified as major cost drivers in HF. Conclusions: Our findings indicate that patients with HF experience worse HRQoL and incur higher costs than individuals without HF or patients with other chronic diseases. Early treatment of HF and careful disease management to slow progression and to limit the requirement for hospital admission are likely to reduce both the humanistic burden and economic impact of HF.

Health State Utilities of Patients with Heart Failure: A Systematic Literature Review

“…However, periods of stable heart function are punctuated by acute events (also referred to as decompensations). Chronic HF is commonly classified by the New York Heart Association (NYHA) classification, which describes the severity of symptoms and their impact on the patient’s physical activity and daily functioning [ 4 – 6 ]. Acute heart failure (AHF) is the rapid onset of new or worsening of symptoms and signs of HF, requiring urgent medical attention [ 7 ].…”

“…New treatments and models of care are under exploration for both chronic HF with reduced left ventricular ejection fraction (HFrEF, LVEF < 40%) and chronic HF with preserved left ventricular ejection fraction (HFpEF, LVEF ≥ 50%). As HF has a substantial impact on health-related quality of life (HRQoL) [ 6 ], it is important to understand the effect of treatment on HRQoL and consequently assess cost effectiveness (CE) through a cost-utility analysis, where effectiveness is measured in terms of quality-adjusted life-years (QALYs). Health state utility values can be obtained via generic measures, such as the EQ-5D, or condition-specific measures.…”