Cost of illness: acute coronary syndrome in Switzerland
At a glance
- Project leader : Prof. Dr. Klaus Eichler, Prof. Dr. Simon Wieser
- Project budget : CHF 100'000
- Project status : completed
- Funding partner : Third party (Astra Zeneca)
Description
QUESTIONS UNDER STUDY: To perform a cost-of-illness study of
acute coronary syndrome (ACS) in Switzerland from a societal
perspective, evaluating direct costs, production losses and
intangible costs in terms of quality adjusted life years (QALYs)
lost.
METHODS: A bottom-up incidence-based approach was used. Data
concerning patients with one or more ACS
events were extracted from a national hospital database and from
mortality statistics. Inpatient costs included acute care and
rehabilitation. Outpatient costs included costs for ambulance,
visits to GP and cardiologist, outpatient diagnostics, medication
and rehabilitation. Production losses included absenteeism,
permanent disability and premature death. Intangible costs were
calculated on previously published QALY weights. Cost data were
derived from official price lists, literature and experts. Future
costs and QALYs lost were discounted.
RESULTS: In 2008 14,955 patients experienced a total of 16,815 ACS
events; 2,752 died as a consequence of these. The resulting 19,064
hospital stays had an average acrosshospital length of stay of 9.1
days per patient. Total direct costs of ACS amounted to 630 Mio
Swiss Francs (CHF) for society and CHF 462 Mio for health insurers.
Total direct costs were dominated by costs of myocardial
infarction: ST-elevation 45.8%, non-ST-elevation 35.8%. Production
losses were CHF 519 Mio and intangible costs resulted in
49,878 QALYs lost.
CONCLUSIONS: ACS causes considerable costs in terms of direct
medical expenditures, lost production, suffering and premature
death, even without taking into account costs for its chronic
consequences such as congestive heart failure.