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Patient and caregiver productivity loss and indirect costs associated with cardiovascular events in Europe

Session Poster Session 3

Speaker Kornelia Kotseva

Congress : ESC Congress 2018

  • Topic : e-cardiology / digital health, public health, health economics, research methodology
  • Sub-topic : Health Economics
  • Session type : Poster Session
  • FP Number : P2561

Authors : K Kotseva (London,GB), L Gerlier (Zaventem,BE), E Sidelnikov (Zug,CH), L Kutikova (Zug,CH), M Lamotte (Zaventem,BE), L Annemans (Ghent,BE), P Amarenco (Paris,FR)

Authors:
K. Kotseva1 , L. Gerlier2 , E. Sidelnikov3 , L. Kutikova3 , M. Lamotte2 , L. Annemans4 , P. Amarenco5 , 1Imperial College London, Cardiovascular Medicine - London - United Kingdom , 2IQVIA, Real-World Evidence Solutions - Zaventem - Belgium , 3Amgen Europe GmbH, Global Health Economics - Zug - Switzerland , 4Ghent University, Public Health - Ghent - Belgium , 5Hospital Bichat-Claude Bernard, Neurology and Stroke Center - Paris - France ,

Citation:
European Heart Journal ( 2018 ) 39 ( Supplement ), 503

Introduction: Burden of cardiovascular events (CVE) on productivity is not well described in Europe.

Purpose: A cross-sectional survey in 7 European countries aimed to estimate the productivity loss/indirect costs in the first year following an acute coronary syndrome (ACS) or a stroke.

Methods: Productivity loss (patient absenteeism/presenteeism, and caregiver help) in the past 4 weeks was collected. Productivity Cost Questionnaire was used during a cardiologist/neurologist visit after the patient returned to work, and 3–12 months after index CVE hospitalization. Reported time loss was averaged across patients, extrapolated up to 1 year and combined with initial hospitalization and sick leave. Mean days lost were valued according to country labor cost (€2018).

Results: Analysis included 196 ACS (86% myocardial infarction) and 198 stroke (99% ischemic) patients with, respectively, mean (standard deviation) age 53 (8) and 53 (10) years, 86 and 78% men, 27 and 20% obese, 49 and 58% with elevated LDL-cholesterol on lipid treatment, 28 and 30% with elevated blood pressure, 13 and 11% with type 2 diabetes, 28 and 25% with multiple CVE and 77% (stroke) with modified Rankin scale ≤1. Across countries, mean (range) total productivity loss after ACS was 70 days (47–91) and 68 days (45–88) after stroke. Mean absenteeism accounted for 53 and 47 days lost in ACS and stroke patients, respectively. On average, 6 days were lost due to presenteeism by ACS patients and 9 days by stroke patients. Further, 11 and 12 days were lost in the year after ACS and stroke due to caregiver help. Associated indirect cost ranged from €5,263–43,205 (ACS) and €8,500–28,280 (stroke) (Table).

Patients with vs. without multiple CVE tended to be more affected, with 80 (ACS) and 73 (stroke) days lost.

Conclusion: Our results suggest that productivity loss in the first year following ACS or stroke is substantial, amounting to 25% of annual work-days lost by patients plus 5% lost by caregivers. The main driver of productivity loss is absenteeism followed by caregiver help.

Mean (SD) annual days lost and cost
ACSAbsenteeismPresenteeismCare-giverTotal costStrokeAbsenteeismPresenteeismCare-giverTotal cost
N(days)(days)(days)(€)N(days)(days)(days)(€)
Belgium3041 (42)4 (8)16 (67)19,234 (24,903)2332 (45)16 (34)20 (57)21,732 (25,927)
France939 (33)8 (10)6 (12)15,290 (11,276)2945 (54)11 (18)13 (51)20,079 (27,420)
Poland3865 (85)10 (25)16 (46)29,131 (39,314)3062 (85)8 (18)19 (42)28,280 (32,111)
Portugal3936 (37)2 (5)10 (42)5,263 (6,911)3157 (70)7 (20)12 (38)8,500 (11,258)
Spain3360 (49)6 (28)0 (2)11,366 (8,844)2736 (30)11 (29)10 (36)9,922 (10,994)
Switzerland2475 (80)4 (11)10 (23)43,205 (44,026)3538 (51)4 (10)3 (10)22,011 (25,395)
United Kingdom2351 (49)14 (29)16 (46)14,652 (14,984)2358 (65)7 (15)7 (23)13,027 (12,699)

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