Patient and caregiver productivity loss and indirect costs associated with cardiovascular events in Europe

Kotseva, Kornelia; Gerlier, L.; Sidelnikov, Eduard; Kutikova, Lucie; Lamotte, M; Amarenco, Pierre; Annemans, Lieven

doi:10.1177/2047487319834770

Cited by 48 publications

(48 citation statements)

References 21 publications

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“…Additional sources reporting patient and caregiver days lost after MI and stroke, and home care post stroke were used in CAD and PAD tunnel states. 32 , 37 …”

Section: Methodsmentioning

confidence: 99%

Rivaroxaban plus aspirin for the prevention of ischaemic events in patients with cardiovascular disease: a cost-effectiveness study

Petersohn

Pouwels

Ramaekers

et al. 2020

European Journal of Preventive Cardiology

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Background Dual pathway inhibition with 2.5 mg rivaroxaban twice daily plus 100 mg aspirin once daily may be a promising alternative to 100 mg aspirin antiplatelet therapy for the prevention of cardiovascular events in patients with coronary artery disease and/or peripheral arterial disease. However, treatment costs and bleeding risks are higher, and there is another treatment option for peripheral arterial disease, 75 mg clopidogrel. A comprehensive assessment of benefits, risks and costs of dual pathway inhibition versus standard of care is needed. Methods We used a state transition model including cardiovascular, ischaemic limb and bleeding events to compare dual pathway inhibition to aspirin antiplatelet therapy in coronary artery disease, and additionally to clopidogrel antiplatelet therapy in peripheral arterial disease patients. We calculated the incremental cost-effectiveness ratio from costs and quality-adjusted life-years of lifelong treatment, and the cost-effectiveness probability at a €50,000/quality-adjusted life-year threshold. Results Quality-adjusted life-years and costs of dual pathway inhibition were highest, the incremental cost-effectiveness ratios versus aspirin were €32,109 in coronary artery disease and €26,381 in peripheral arterial disease patients, with 92% and 56% cost-effectiveness probability, respectively (clopidogrel was extendedly dominated). Incremental cost-effectiveness ratios were below €20,000 in comorbid peripheral arterial disease patients and coronary artery disease patients younger than 65 years, incremental cost-effectiveness ratios were above €50,000 in carotid artery disease patients and coronary artery disease patients older than 75 years. Conclusion Lifelong preventive treatment of coronary artery disease and peripheral arterial disease patients at risk of cardiovascular events with dual pathway inhibition improves health outcomes and seems overall cost-effective relative to aspirin antiplatelet therapy and also to clopidogrel antiplatelet therapy for peripheral arterial disease, particularly in comorbid patients, but not in older patients and in carotid artery disease patients. These findings may warrant a targeted approach.

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“…Additional sources reporting patient and caregiver days lost after MI and stroke, and home care post stroke were used in CAD and PAD tunnel states. 32 , 37 …”

Section: Methodsmentioning

confidence: 99%

Rivaroxaban plus aspirin for the prevention of ischaemic events in patients with cardiovascular disease: a cost-effectiveness study

Petersohn

Pouwels

Ramaekers

et al. 2020

European Journal of Preventive Cardiology

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“…A consistent theme across the included studies was the amount of work and challenges associated with caregiving, and the lack of preparedness, which contributed to physical, mental and emotional stress for both care recipients and caregivers 17 65. The review findings are complementary to other research on caregiver strains across different populations 66.…”

Section: Discussionmentioning

confidence: 85%

“…Petrini et al 16 highlight the need to support female caregivers as they have a greater burden of care 16. Higher burden of care is associated with increased indirect costs due to loss of productivity (workdays) 17…”

Section: Introductionmentioning

confidence: 99%

Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies

et al. 2019

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ObjectivesTo provide a comprehensive synthesis of informal caregivers’ experiences of caring for a significant other following discharge from cardiac surgery.DesignSystematic integrated review without meta-analysis.Data sourcesA bibliographic search for publications indexed in six databases (Cochrane Library, CINAHL, MEDLINE, EMBASE, AMED and PsycINFO), including a scan of grey literature sources (GreyNet International, Google Scholar, Web of Science, WorldCat and the Clinical Trials Registry) was conducted in October 2018.Eligibility criteria for selecting studiesStudies were included if they described views and perspectives of informal caregivers of cardiac surgery patients (non-intervention studies (qualitative and quantitative)), and the effectiveness of interventions to evaluate support programme for informal caregivers of cardiac surgery patients (intervention studies).ResultsOf the 4912 articles identified in searches, 42 primary research studies were included in a narrative synthesis with 5292 participants, including 3231 (62%) caregivers of whom 2557 (79%) were women. The median sample size across studies was 96 (range 6–734). Three major themes emerged from the qualitative study data: (1) caregiver information needs; (2) caregiver work challenges and (3) caregivers adaption to recovery. Across the observational studies (n=22), similar themes were found. The trend across seven intervention studies focused on caregiver information needs related to patient disease management and symptom monitoring, and support for caregivers to reduce symptoms of emotional distress.ConclusionInformal caregivers want to assist in the care of their significant others after hospital discharge postcardiac surgery. However, caregivers feel insecure and overwhelmed and they lack clear/concise discharge information and follow-up support during the early at-home recovery period. The burden of caregiving has been recognised and reported since the early 1990s, but there remains a limited number of studies that assesses the effectiveness of caregiver interventions.PROSPERO registration numberCRD42018096590.

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“… 5 In Europe, CHD-related productivity losses amount to €13 953 per person per year. 6 In Indonesia, the percentage of productivity loss attributable to CHD due to absenteeism and presenteeism is estimated to be 2.8% and 6.8% of GDP per year, respectively. 4…”

Section: Introductionmentioning

confidence: 99%

Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling

et al. 2020

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ObjectivesThe impact of coronary heart disease (CHD) and its effect on work productivity at a population level remains unknown in Indonesia. This study estimates the health and productivity lost to CHD in terms of years of life, quality-adjusted life years (QALYs) and productivity-adjusted life years (PALYs).Setting and participantsA life-table model was constructed to simulate the experiences of Indonesians currently aged 15–54 years (working age) with CHD, followed-up to 55 years (retirement age). The life-table analysis was then repeated assuming that the cohort did not have CHD. Differences in the results reflected the impact of CHD. Demographical, prevalence and mortality data were based on the 2017 Global Burden of Disease study and 2018 Indonesian National Health Survey. Costs, productivity indices and utilities were derived from published sources. The cost of each PALY was assumed to be equivalent to gross domestic product per equivalent full-time worker (US$11 765). Future costs and outcomes were discounted by 3% annually.Primary and secondary outcome measuresDifferences in total deaths, years of life and PALYs represented the impact of CHD.ResultsAt present, 1 954 543 (1.45%) Indonesians of working-age have CHD. By retirement age, it was estimated that CHD resulted in 32 492 (36.6%) excess deaths, 128 132 (0.5%) years of life lost, 2 331 495 (10.5%) QALYs lost and 1 589 490 (6.9%) PALYs lost. The economic impact of lost productivity amounted to US$33.3 billion, and healthcare costs to US$139 billion.ConclusionThe health and economic burden of CHD in Indonesia looms large. This highlights the importance of its prevention and control, strategies for which, if effective, will deliver financial return.

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Patient and caregiver productivity loss and indirect costs associated with cardiovascular events in Europe

Cited by 48 publications

References 21 publications

Rivaroxaban plus aspirin for the prevention of ischaemic events in patients with cardiovascular disease: a cost-effectiveness study

Rivaroxaban plus aspirin for the prevention of ischaemic events in patients with cardiovascular disease: a cost-effectiveness study

Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies

Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling

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