EU spend on cardiovascular disease may have topped 181 billion euro in 2005
A new paper published in the European Heart Journal reveals the staggering cost of cardiovascular disease in the EU -169 billion euro in 2003. The researchers from Oxford University in the UK set out to unravel the cost of this ubiquitous disease, the leading cause of illness and death in the 25 EU member countries. To put the 169 billion euro into context, the EU research budget for the four-year Sixth Framework Programme (FP6) was set at 17.5 billion euro in 2002. Lead author José Leal said of cardiovascular disease (CVD): 'Until now, there has been no systematic cost-of-illness study to evaluate its economic burden on the EU. The objective of this study is to help policy makers assess the impact of their policies and set priorities for research spending. It also highlights the need for comparable and accurate information on cardiovascular disease prevalence, mortality and healthcare resources within all EU countries, as well as the EU as a whole.' The researchers reached the figure through analysing estimates for total covered healthcare, which includes primary, outpatient, emergency and in-patient care and medication. They then factored in the costs of unpaid care and lost earnings due to illness and premature death. One in every 100 EU citizens has his or her daily life disrupted by the spectre of cardiovascular disease - some 4.4 million EU citizens. It takes the largest chunk of EU healthcare costs - 12 per cent of the total EU spend. In 2003, there were 126 million hospital bed days and 268.5 million working days lost to heart disease. Of the 169 billion euro annual EU spend on cardiovascular disease, healthcare is by far the largest portion, accounting for 62 per cent of all costs. Productivity losses and informal care represented 21 per cent and 17 per cent of costs, respectively. Two million people died as a result of cardiovascular disease in 2003. Interestingly, the highest profile diseases - coronary heart disease and cerebrovascular disease - accounted for two-thirds of all the deaths, but only 47 per cent of associated costs. This means that other, less deadly or debilitating forms of heart disease, such as high blood pressure, are an even greater economic burden on EU member states. Deaths alone accounted for 24.4 billion euro of the total EU cost. The researchers also managed to factor into the study the costs of informal care for the first time. They estimated that 2.98 million sufferers received 2.95 billion hours of help from unpaid carers, representing 29 billion euro. An estimated 1.375 million people were involved in providing unpaid care to patients with coronary heart disease or cerebrovascular disease alone. There were found to be large discrepancies in the costs to individual nations. The UK spent the largest proportion of its healthcare spending on cardiovascular disease - 17.1 per cent of its healthcare budget. This was closely followed by Germany, Slovakia, Estonia, Lithuania, the Czech Republic and Poland. The two countries with the lowest proportion of cardiovascular healthcare spend were Malta at 2 per cent and Ireland at 4.4 per cent. 'The aim of our study was not to judge whether countries were spending too much or too little relative to others,' said Mr Leal. 'Establishing the cost of an illness doesn't permit us to say if a country is spending too much or too little. The real use is that it will allow comparisons to be made within countries, and the EU as a whole, of the burden imposed by different diseases. This should help potentially to prioritise scarce resources.' The EU Member States were found to spend far less than their American counterparts. Average per capita spend in the EU on heart disease is 230 euro, while in the US, the figure stands at 715 euro. Co-author of the paper, Ramon Luengo-Fernandez, said: 'The 169 billion euro cost of cardiovascular disease to the EU is more than any other published estimates for other diseases, and if anything, is likely to be an under-estimate. Our figures are for 2003: taking current trends in medical price and wage inflation into account, we estimate the costs will have risen to around EUR 181 billion in 2005. 'International studies as big as this one do require substantial research input and funding, but this type of analysis should be performed regularly at five to eight-year intervals to measure the impact of policy decisions or developments in healthcare. It has, to give a concrete example, the potential for monitoring the contributions made to reducing the burden of CVD of interventions by policies such as legislation to curb smoking,' he said.