Simulation analysis of economic burden in hypertension and myocardial infarction treatment with beta blockers

Abstract

Background: Hypertension has become a veryfrequent chronic disease worldwide and Slovenia is no exception. It is defined as a serious risk factor for developing different cardiovascular diseases. Several important studies proved that cardiovascular diseases are the main reason of deaths in more than 50 % of cases in the developed countries. All mentioned facts are indicatingthat treatment costs in patients with hypertension and cardiovascular diseases representan important economic burden, which cannot be neglected. It may also be expected that in the next few decades the situation will become evenworse. The reasons are the expected earlier disease development due to unhealthy life style and the fact that people live longer and populations are growing older. The mentioned facts have motivated the study, which would enable the estimation of patients’ number in the observed population and the evaluation of economic burden when using beta blockers, drugs which have become an important choice in antihypertensive treatment and are also used in patients with different cardiovascular complications. The projectionsindicating the expected trends of mentioned problems in the forthcoming decades would also be of interest.Methods: To answer some of the indicated questions, a simulation model was developed, which enabled the prediction of patients with hypertension and the influence of this disease to the development of myocardial infarction. Modeling was performed using the available statistical data and published studies. Main attention was devoted to the circumstances in Slovenia, but the results were also verified using the available data for some other countries. Combination of simulation results with demographic data enabled the estimation of the number of patients observed. In addition, expenses for the observed groupsof patients were evaluated and, based on that, the economic burden was estimated. The mentioned expenses include hospitalizations, drugs required and the estimated mortality-related expenses. The developed model was accomplished with dynamical mathematical structure predicting the development of population number in Slovenia in the forthcoming decades, taking into account that the demographic properties remainunchanged. Also the observation of potential scenario regarding patients’ number and thus expected economic burden distribution among younger and older population is made possible.Results: In the paper simulation results are presented which enable the estimation of patients with hypertension and their connection with those who have experienced myocardial infarction. It is possible to observe the prevalence and the number of patients in Slovenia by age. In addition, economic burden associated with the observed groups of patients is calculated taking into account needed drugs, hospitalizations and patient mortality. In such circumstances it is possible to expect that in the group of one million people approximately 264,000 are patients with hypertension for whom, when healed optimally with beta blockers, over EUR 13 million is needed per year. In the same group of one million people are also patients with myocardial infarction. Among them 11 % experienced infarction within the current year. This amounts to more than 22,000 such patients and over EUR 22 million needed for them each year. In the case of unchanged statistical demographic characteristics in the future, it can be expected that in 50 years relative economic burden for active population would become twice as high as it is now.Conclusions: For optimal treatment, hospitalization and due to mortality more than EUR 35 million per year would be needed for patients with hypertension (around 260,000 patients) and for those who have experienced myocardial infarction (around 22,000) if observing the population of one million people. As the population is growing older, it can be expected that the relative economic burden will become significantly greater for active population in the forthcoming decades.