Costs and Healthcare Utilisation of Patients With Heart Failure in Spain

Abstract

Background: To evaluate the cumulative costs and healthcare utilisation in heart failure (HF) patients in Spain. This was also analyzed among the DAPA-HF like population.Methods: Observational, retrospective, population-based study using BIG-PAC database, which included data from specialized and primary care of people aged ≥18 years, from 7 autonomous communities in Spain, who received care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until the last year of follow-up (2019).Results: We identified 17,163 patients with HF (year 2015: mean age 77.3±11.8 years, 53.5% men, 51.7% systolic HF and 43.6% on NYHA functional class II). During the 2015-2019 period, total HF associated costs reached 15,373 Euros per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a progressive decrease of cardiovascular disease hospital costs per year (from 2,834 Euros in 2015 to 2,146 Euros in 2019, P<0.001), as well as cardiovascular and diabetic medication costs. Hospitalization and medication costs were higher in the DAPA-HF like population.Conclusions: During the 2015-2019 period, costs of patients with HF in Spain were substantial, being HF hospitalizations the most important determinant. Medication costs represented only a small proportion of total HF costs. Improving HF management, particularly through the use of those drugs that reduce HF hospitalization may be helpful to reduce HF burden.