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Cost of HF care projected to double by 2030
Direct and indirect costs to treat HF are expected to more than double, from $31 billion in 2012 to $70 billion in 2030, according to a new American Heart Association policy statement.
By 2030, it is forecasted that one in every 33 US adults will have HF, up 46% from 5 million in 2012 to 8 million in 2030. The aging population will bear the greatest increase in HF. Researchers projected a 66% increase in HF by 2030 among those aged older than 80 years.
Paul A. Heidenreich
“I was struck primarily by the number of patients with HF that is going to increase to [more than] 8 million by 2030 — almost a 50% increase from where we are today,” Paul A. Heidenreich, MD, MS, FAHA, chair of the policy statement and professor of medicine at Stanford University School of Medicine, said during a press conference. “That is a relatively short period of time for a large number of patients who are going to be treated.”
According to cost estimates, real total direct medical costs of HF are projected to increase from $21 billion in 2012 to $53 billion in 2030. Further, assuming all costs of care for HF patients are attributable to HF, the direct cost estimate of treating patients with HF in 2030 is projected to be $160 billion, according to the policy statement.
“The cost would be substantial, with each US adult, on average, paying $244 annually by 2030 to care for … patients with HF,” Heidenreich and colleagues wrote in the statement.
Researchers estimated future costs of HF using a methodology developed by the AHA. The model assumes that HF prevalence will remain constant by race, sex and age, and that increasing costs and technological innovation will continue at the same rate. The model does not double count costs attributed to comorbid conditions.
The statement also includes recommendations for reducing the impact of HF and managing the increasing number of Americans with HF:
- More effective dissemination and use of guideline-recommended therapies to prevent HF and improve overall survival. Other preventative guidelines for hypertension, cholesterol, smoking, obesity and physical activity, if successfully implemented, could also reduce the incidence of HF.
- Improving coordination of care from hospital to home.
- Specialized training for physicians, nurses, pharmacists and other health care professionals to meet the needs of the growing HF population. According to the Heart Failure Society of America, in 2005 there were 48 active advanced training programs and 17 institutions are considering adding programs. An Advanced Heart Failure and Transplant Cardiology certifiable subspecialty suggested by the American Board of Internal Medicine has also generated interest.
- Reducing racial, ethnic and socioeconomic disparities in HF prevention and closing gaps in health outcomes.
- Increased access to palliative and hospice care for patients with advanced-stage HF.
“Awareness of risk factors and adequately treating them is the greatest need,” Heidenreich said.
For more information:
Heidenreich PA. Circ Heart Fail. 2013;doi:10.1161/HHF.0b013e318291329a.
Disclosure:Heidenreich reports no relevant financial disclosures.
Perspective
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The numbers are high with regard to how much HF is going to cost this country. These projections are well-founded and reflect a concern that HF is the No. 1 reason why patients older than 65 years are hospitalized — that number will only increase.
The recommendation for any epidemic is to try to prevent it. That's clearly what we need to do with HF. It always comes back to the same fundamental issues of preventing hypertension, CAD, obesity and other CV problems to help reduce the incidence of HF as well. The American health system is much better at dealing with disease than dealing with prevention. For example, one thing I like about the Affordable Care Act is the emphasis on prevention.
Other countries, such as England, have recognized a problem with HF and have a coordinated effort across cardiology, primary care and hospitals devoted to caring for patients with HF and recognizing early symptoms of HF. We need a coordinated system in the United States for recognizing what leads to HF, how to prevent HF and quality measures proven to effectively treat HF.