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Medical costs of coronary artery disease in the United States
E H Wittels1, J W Hay, A M Gotto
1Department of Internal Medicine, Baylor College of Medicine, Methodist Hospital, Houston, Texas 77030.
Insights
The cost of coronary artery disease (CAD) was modeled using 5 primary events. Acute myocardial infarction had the highest 5-year cost at $51,211, while sudden death was the least expensive at $9,078.
Area of Science:
- Cardiovascular Medicine
- Health Economics
Background:
- Coronary artery disease (CAD) is a significant public health concern with substantial economic impact.
- Understanding the cost of CAD is crucial for resource allocation and healthcare policy.
Purpose of the Study:
- To develop a model for estimating the 5-year costs associated with major coronary artery disease (CAD) events.
- To calculate the healthcare expenditures for diagnostic and therapeutic services related to CAD management.
Main Methods:
- A cost model was developed based on five primary CAD events identified in the Framingham Study.
- Medical decision algorithms were used to link diagnostic and therapeutic costs to patient management.
- Patient costs were tracked for five years post-diagnosis or until death to establish average cost estimates.
Main Results:
- The estimated 5-year costs for CAD events in 1986 USD were: acute myocardial infarction ($51,211), angina pectoris ($24,980), unstable angina pectoris ($40,581), sudden death ($9,078), and nonsudden death ($19,697).
- Major surgical procedures also incurred significant costs: coronary artery bypass surgery ($32,465) and angioplasty ($26,916) per case over five years.
- The overall high cost of CAD reflects advancements in technology and the availability of more effective, albeit expensive, therapies.
Conclusions:
- The developed model provides valuable estimates for the 5-year economic burden of major coronary artery disease (CAD) events and interventions.
- These cost estimations are essential for healthcare planning and evaluating the economic impact of CAD management strategies.
- The rising costs associated with CAD underscore the need for continued research into cost-effective prevention and treatment modalities.
Abstract:
A model has been developed to determine the cost of coronary artery disease (CAD) based on the 5 primary events identified in the Framingham Study: acute myocardial infarction, angina pectoris, unstable angina pectoris, sudden death and nonsudden death. The costs for diagnostic and therapeutic service for patients with CAD were linked to medical decision algorithms outlining the diagnosis and management of patients with CAD. Because CAD is a changing illness not represented by a single event, the algorithm tracked patients for 5 years after the time of diagnosis, or until death, to develop average cost estimates. The estimated 5-year costs (in 1986 United States dollars) of the 5 CAD events were: acute myocardial infarction $51,211, angina pectoris $24,980, unstable angina pectoris $40,581, sudden death $9,078 and nonsudden death $19,697. The costs of major CAD surgical procedures were also calculated because of their impact on health care costs for patients with CAD. These include: coronary artery bypass surgery per case over 5 years $32,465, and angioplasty per case over 5 years $26,916. The high cost of CAD reflects the improved technology and more effective and expensive therapies now available.