The economic impact of hypercholesterolemia and mixed dyslipidemia: A systematic review of cost of illness studies

Abstract

Hypercholesterolemia is a clinically relevant condition with an ascertained role in atherogenesis. In particular, its presence directly correlates to the risk of atherosclerotic cardiovascular disease (ASCVD). As known, cardiovascular diseases pose a significant economic burden worldwide; however, a clear picture of the economic impact of ASCVD secondary to hypercholesterolemia is lacking. This study aiming at conducting a systematic review of the current literature to assess the economic impact of familial hypercholesterolemia (FH), non-familial hypercholesterolemia (non-FH) or mixed dyslipidemia. A literature search was performed in Medline/PubMed and Embase database up to September 1st, 2020, exploring evidence published from 2010. The literature review was conducted in accordance with PRISMA guidelines. To be included the studies must be conducted on people who have been diagnosed with familial hypercholesterolemia, non-familial hypercholesterolemia or mixed dyslipidemia, and report data/information on costs attributable to these conditions and their sequelae. A total of 1260 studies were retrieved. After reading the titles and abstract, 103 studies were selected for full reading and eight met the criteria for inclusion. All but one studies were published in the American continent, with the majority conducted in US. An observational design with a prevalence approach were used and all estimated the economic burden of CVD. Direct cost estimates as annual average health expenditure on all population, ranging from $17 to $259 million. Few studies assessing the economic impact of hypercholesterolemia are available in the literature and new researches are needed to provide a more updated and reliable picture. Despite this scarceness of evidence, this review adds important data for future discussion on the knowledge of the economic impact of hypercholesterolemia and costs of care associated to this condition, with important implication for public health researches and novel therapies implementation.

Impact of Inflammatory Bowel Disease (IBD) and IBD Medications on Risk of Hyperlipidemia and in vitro Hepatic Lipogenic-Related Gene Expression: A Population-Based Cohort Study

“…Moreover, Kristensen et al ( 13 ) found that compared with controls, patients with IBD presented an increased risk of stroke [relative risk (RR), 1.15; 95% CI, 1.05–1.27] and hospitalization due to heart failure (RR, 1.37; 95% CI, 1.26–1.49) ( 13 ). Since, hyperlipidemia is a major risk factor for stroke, which is a leading cause of death ( 54 , 55 ), may play a role in this situation. In addition, a case-control study reported an increased risk of stroke in patients with IBD (aOR, 2.93; 95% CI, 1.44–5.98) especially in those younger than 50 years of age ( 56 ).…”

Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID‐19 pandemic

“…This remains a serious barrier to proper prevention, given the higher costs needed to treat FH, especially during the pandemic. The economic burden of these patient cohorts was quantified in a recent systematic review, wherein FH or nonfamilial dyslipidemia faced significant economic burdens from CVD, with an annual average expenditure ranging from $17 to $259 million in these communities alone 63 . Often, these costs disproportionately affected FH patients who had previous CV events, where the significant economic burden was attributed by healthcare utilization, such as in‐patient services and interventions during hospitalizations, as well as following up with secondary prevention for FH 63 .…”

“…The economic burden of these patient cohorts was quantified in a recent systematic review, wherein FH or nonfamilial dyslipidemia faced significant economic burdens from CVD, with an annual average expenditure ranging from $17 to $259 million in these communities alone 63 . Often, these costs disproportionately affected FH patients who had previous CV events, where the significant economic burden was attributed by healthcare utilization, such as in‐patient services and interventions during hospitalizations, as well as following up with secondary prevention for FH 63 . This was supported by a burden model developed in Turkey, which determined that the indirect economic burden associated with FH with CVD accounting for 67.5% of overall costs 64 …”

“…63 Often, these costs disproportionately affected FH patients who had previous CV events, where the significant economic burden was attributed by healthcare utilization, such as in-patient services and interventions during hospitalizations, as well as following up with secondary prevention for FH. 63 This was supported by a burden model developed in Turkey, which determined that the indirect economic burden associated with FH with CVD accounting for 67.5%…”

Carga económica de la hipercolesterolemia en población con alto riesgo cardiovascular en México

“…Por otra parte, la atención de las dislipidemias implica un alto impacto financiero para los sistemas de salud. En este sentido, una revisión sistemática de estudios de costo de HC y dislipidemia mixta encontró que las ECV en pacientes con HC no solo tienen un alto impacto en el consumo de recursos y los costos directos, sino también en los costos sociales 8 .…”