Faculty of Economics, Centre for Economics and International Studies, Economic Evaluation and Health Technology Assessment, University of Rome "Tor Vergata", Via Columbia, 2, 00133, Rome, Italy.
Division of Cardiology, San Filippo Neri Hospital, Rome, Italy.
Clin Drug Investig. 2024 Oct;44(10):739-747. doi: 10.1007/s40261-024-01365-z. Epub 2024 Sep 9.
Atherosclerotic cardiovascular diseases remain the primary cause of mortality in Italy. Individuals with a history of acute coronary syndrome, peripheral arterial disease, and ischemic stroke/transient ischemic attack face an elevated risk of recurrent major adverse cardiovascular events, including mortality. The population aging, coupled with increasing risk factors such as diabetes mellitus and obesity, exacerbates the disease's economic impact.
This study aims to comprehensively assess the economic burden of atherosclerotic cardiovascular diseases in Italy, specifically focusing on direct healthcare costs.
We analyzed real-world data from administrative databases in the Marche region and Local Health Unit Umbria 2. The economic burden of patients discharged with acute coronary syndrome, peripheral arterial disease, and ischemic stroke/transient ischemic attack was evaluated, with a focus on direct costs associated with hospitalizations, drugs, and outpatient visits. Results were stratified by age, sex, comorbidities at baseline, and adherence to lipid-lowering therapy and antihypertensive agents.
Annually, nearly 350,000 patients were hospitalized for peripheral arterial disease, acute coronary syndrome, or ischemic stroke/transient ischemic attack. Direct health costs averaged €7190 per patient over a 2-year follow-up, with hospitalizations accounting for nearly 70% of the total. Male patients incurred significantly higher costs (€7467) than female patients (€6625). Costs correlated positively with age and with the number of baseline comorbidities, with a range from €5259 (0-1 comorbidities) to €17,095 (4+ comorbidities). Costs were significantly lower in adherent subjects (€6813) compared with non-adherent subjects (€7757).
This study provides valuable insights into the economic implications of atherosclerotic cardiovascular diseases in Italy, emphasizing the necessity of a comprehensive approach to preventive measures, optimal medication adherence, and lifestyle modifications to mitigate its impact.
动脉粥样硬化性心血管疾病仍然是意大利死亡的主要原因。患有急性冠状动脉综合征、外周动脉疾病和缺血性卒中和短暂性脑缺血发作的个体面临着复发性主要不良心血管事件的风险增加，包括死亡。人口老龄化，加上糖尿病和肥胖等风险因素的增加，使疾病的经济负担更加严重。
本研究旨在全面评估意大利动脉粥样硬化性心血管疾病的经济负担，特别是直接医疗保健成本。
我们分析了马尔凯地区和翁布里亚 2 号地方卫生单位的行政数据库中的真实世界数据。评估了急性冠状动脉综合征、外周动脉疾病和缺血性卒中和短暂性脑缺血发作出院患者的经济负担，重点关注与住院、药物和门诊就诊相关的直接成本。结果按年龄、性别、基线时的合并症以及降脂和降压药物的依从性进行分层。
每年有近 35 万名患者因外周动脉疾病、急性冠状动脉综合征或缺血性卒中和短暂性脑缺血发作住院。在 2 年的随访期间，每位患者的直接健康成本平均为 7190 欧元，住院费用占总费用的近 70%。男性患者的费用（7467 欧元）明显高于女性患者（6625 欧元）。成本与年龄和基线合并症数量呈正相关，范围从 5259 欧元（0-1 种合并症）到 17095 欧元（4 种或更多种合并症）。与不依从的患者（7757 欧元）相比，依从的患者（6813 欧元）的成本显著降低。
本研究提供了意大利动脉粥样硬化性心血管疾病经济影响的有价值的见解，强调需要采取综合措施预防措施、优化药物依从性和生活方式改变，以减轻其影响。
