SPC365

Heart Failure therapy cost and its impact on monthly income in the Portuguese population

Session: Posters (Sessão 6 - Écran 1) - Insuficiência Cardíaca - vários
Speaker: Inês Fialho

Congress: CPC 2023
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.7 Chronic Heart Failure - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Inês Fialho; Filipa Gerardo; Mariana Passos; Inês Miranda; Carolina Mateus; Joana Lima Lopes; Marco Beringuilho; Ana Oliveira Soares; David Roque

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Background: </span></strong><span style="font-size:11pt">Heart Failure (HF) therapy is based on a core of 4 therapeutic classes with a considerable benefit on mortality and HF hospitalizations. Some drug classes are expensive, and so the total cost of HF therapy could have a negative impact on patient&rsquo;s compliance.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Objectives: </span></strong><span style="font-size:11pt">To evaluate the cost of HF therapy in Portugal and its impact on the monthly income of the Portuguese population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Methods: </span></strong><span style="font-size:11pt"><span style="color:black">Retrospective single center study<strong> </strong>of HF patients hospitalized between January 2021 and September 2022. </span></span><span style="font-size:11pt">Demographics, comorbidities, and </span><span style="font-size:11pt"><span style="color:black">drugs prescribed at discharge were recorded. The minimum, average, and maximum monthly costs of HF therapy at discharge were calculated through the sum of the minimum, average and maximum cost of each drug according to the Portuguese general reimbursement regime (information available on the Portuguese electronic medical prescription platform - PEM). The gross average monthly wage and minimum monthly wage in 2022 were also reviewed, according to data provided by the Portuguese National Statistics Institute.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Results: </span></strong><span style="font-size:11pt">A total of 152<strong> </strong>patients were included. The minimum, average, and maximum monthly costs for the most prescribed HF drugs are presented in Table 1. At discharge, the patient with the cheapest HF therapy (composed only by one drug class) has paid 1,79-7.52&euro;/month and the patient with the most expensive therapy (composed by the four drug classes, including sacubitril-valsartan) has paid 102,81-125.29&euro;/month. The median (IQR) monthly cost of the cheapest HF drug combination was 52.55 (48.30 &ndash; 94.63)&euro;, the average cost was 60.25 (50.02 &ndash; 98.33)&euro;, and the most expensive therapy was 77.23 (54.59 &ndash; 103.17)&euro;. Comorbidities were present in 92.1% (n=139) of HF patients, with hypertension (n=115, 75.2%), dyslipidemia (n=83, 54.2%), coronary artery disease (n=69, 51.1%), atrial fibrillation (n=66, 43.1%), and diabetes (n=50, 32.7%) being the most frequent ones. In Portugal, the </span><span style="font-size:11pt"><span style="color:black">average net wage is 904.5&euro;/month and the minimum net wage is 627.5&euro;/month. The HF therapy cost represents 5.8-8.5% of the average gross monthly wage and 8.4-12.3% of the minimum monthly wage.</span></span></span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusions: </span></span></strong><span style="font-size:11pt"><span style="color:#000000"><span style="font-family:Calibri,sans-serif">HF therapy has a high cost and represents an important expense in the monthly budget of HF patients. The health-related expense of HF patients is still increased by the need for other drugs related to their comorbidities, frequent consultations, and exams. Strategies are needed to prevent high cost from limiting patient&rsquo;s compliance with HF drugs.</span></span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Table 1</span></strong><span style="font-size:11pt"> &ndash; Mean minimum, average, and maximum cost of the most prescribed heart failure drugs at discharge. </span></span></span></span></p>