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Published on: January 15, 2022
Economic burden of cardiovascular disease in the United Kingdom
Kingsley Shih1, Naomi Herz2, Aziz Sheikh3,4
1Department of Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada.
Insights
Cardiovascular disease (CVD) cost the UK £29 billion in 2021/22. Inpatient care drove direct costs, while informal care represented the largest indirect economic burden.
Area of Science:
- Health Economics
- Public Health
- Cardiovascular Disease Research
Background:
- Previous UK cost-of-illness studies on cardiovascular disease (CVD) overlooked long-term care and medical device expenses.
- A comprehensive societal perspective is needed to accurately capture the economic impact of CVD.
Purpose of the Study:
- To quantify the total economic burden of cardiovascular disease (CVD) in the United Kingdom (UK).
- To analyze direct and indirect costs from a societal perspective for fiscal years 2019/20 to 2021/22.
Main Methods:
- A mixed-methods approach combining prevalence-based retrospective review and public sector costing.
- Top-down costing for inpatient, outpatient, emergency, primary care, medications, medical devices, and long-term care.
- Bottom-up costing using survey data to estimate informal care costs and production losses.
Main Results:
- Total CVD costs in the UK reached £29.021 billion in 2021/22, comprising £16.620 billion in direct costs and £12.402 billion in indirect costs.
- Direct costs were dominated by inpatient care (£6.732 bn) and long-term care (£4.649 bn).
- Indirect costs were primarily driven by informal care (£6.377 bn) and production losses due to mortality (£4.544 bn).
Conclusions:
- Cardiovascular disease imposes a substantial economic burden on the UK.
- Inpatient care represents the highest direct cost component.
- Informal care constitutes the most significant indirect cost associated with CVD.
Background And Aims:
Direct (medical and non-medical) and indirect (production losses and informal care) costs of cardiovascular disease (CVD) have been captured in two previous United Kingdom (UK) cost-of-illness studies, but the areas of long-term care and medical device costs were neglected. We aimed to quantify the economic burden of CVD in the UK from a societal perspective between the fiscal years 2019/20 and 2021/22.
Methods And Results:
Mixed-methods study in a prevalence-based retrospective review of economic costs focused on the public sector. Top-down costing was applied to the following areas: inpatient hospital care, outpatient specialist care, emergency care, primary care, medications, medical devices, long-term care, production losses to morbidity, and production losses to mortality. Bottom-up costing was used by applying the marginal effects of having a CVD on several parameters using survey data from the Survey on Health, Aging, and Retirement in Europe to estimate informal care costs. The modelling performed shows that the total costs of CVD in the UK in 2021/22 were £29.021 billion (bn), with direct costs of £16.620 bn and indirect costs of £12.402 bn. The breakdown of direct costs for the UK were inpatient care (£6.732 bn), long-term care (£4.649 bn), medications (£1.940 bn), primary care (£1.556 bn), outpatient care (£1.011 bn), emergency care [£327.6 million (mn)], and medical devices (£404.4 mn). The breakdown of indirect costs for the UK were informal care costs (£6.377 bn), production losses to mortality (£4.544 bn), and production losses to morbidity (£1.481 bn).
Conclusion:
There is a significant economic burden of CVD in the UK, with the highest direct cost resulting from inpatient care and the highest indirect cost resulting from informal care.
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