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. 2022 Aug;10(8):571-580.
doi: 10.1016/j.jchf.2022.05.006. Epub 2022 Jul 6.

Expenditure on Heart Failure in the United States: The Medical Expenditure Panel Survey 2009-2018

Roshni Bhatnagar  1 , Gregg C Fonarow  2 , Paul A Heidenreich  3 , Boback Ziaeian  4
Affiliations

Expenditure on Heart Failure in the United States: The Medical Expenditure Panel Survey 2009-2018

Roshni Bhatnagar et al. JACC Heart Fail. 2022 Aug.

Abstract

Background: With rising United States health care expenditure, estimating current spending for patients with heart failure (HF) informs the value of preventative health interventions.

Objectives: The purpose of this study was to estimate current health care expenditure growth for patients with HF in the United States.

Methods: The authors pooled MEPS (Medical Expenditure Panel Survey) data from 2009-2018 to calculate total HF-related expenditure across clinical settings in the United States. A 2-part model adjusted for demographics, comorbidities, and year was used to estimate annual mean and incremental expenditures associated with HF.

Results: In the United States, an average of $28,950 (2018 inflation-adjusted dollars) is spent per year for health care-related expenditure for individuals with HF compared with $5,727 for individuals without HF. After adjusting for demographics and comorbidities, a diagnosis of HF was associated with $3,594 in annual incremental expenditure compared with those without HF. HF-related expenditure increased from $26,864 annual per person in 2009-2010 to $32,955 in 2017-2018, representing a 23% rise over 10 years. In comparison, expenditure on myocardial infarction, type 2 diabetes mellitus, and cancer grew by 16%, 28%, and 16%, respectively. Most of the cost was related to hospitalization: $12,569 per year. Outpatient office-based care and prescription medications saw the greatest growth in cost over the period, 41% and 24%, respectively. Estimated incremental national expenditure for HF per year was $22.3 billion; total annual expenditure for adults with HF was $179.5 billion.

Conclusions: HF is a costly condition for which expenditure is growing faster than that of other chronic conditions.

Keywords: Medical Expenditure Panel Survey; health care economics; health expenditure; heart failure (HF).

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Conflict of interest statement

Funding Support and Author Disclosures Dr Fonarow has served as a consultant for Abbott, Amgen, AstraZeneca, Bayer, Cytokinetics, Edwards, Janssen, Medtronic, Merck, and Novartis. Dr Ziaeian’s research is supported by AHA SDG 17SDG33630113 and the National Institutes of Health/National Center for Advancing Translational Science (NCATS) UCLA CTSI grant number KL2TR001882. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

FIGURE 1
FIGURE 1. Median Annual Expenditure by Medical Service Category for HF and Non-HF Participants
Median expenditures are calculated only for participants with nonzero expenditure for a particular category of spending. Median expenditure for heart failure (HF) patients was highest in the inpatient setting, and nearly all HF patients required expenditure for medications.
FIGURE 2
FIGURE 2. Trend in 2009–2018 Expenditure Change by Clinical Condition
The rate of overall expenditure growth from 2009 to 2018 was higher for HF-related spending compared with that of cancer or to that of cancer or myocardial infarction
CENTRAL ILLUSTRATION
CENTRAL ILLUSTRATION. Trends in Per-Person Per-Year Expenditure by Service Line, 2009–2018
Annual mean expenditure for patients with heart failure (2009–2018, in 2-year increments). Among participants with heart failure, per person per year expenditure grew in all service lines from 2009–2018.
See this image and copyright information in PMC

Comment in

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