PMID- 36407426 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221122 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Cost analysis of chronic heart failure management in Malaysia: A multi-centred retrospective study. PG - 971592 LID - 10.3389/fcvm.2022.971592 [doi] LID - 971592 AB - BACKGROUND: Estimation of the economic burden of heart failure (HF) through a complete evaluation is essential for improved treatment planning in the future. This estimation also helps in reimbursement decisions for newer HF treatments. This study aims to estimate the cost of HF treatment in Malaysia from the Ministry of Health's perspective. MATERIALS AND METHODS: A prevalence-based, bottom-up cost analysis study was conducted in three tertiary hospitals in Malaysia. Chronic HF patients who received treatment between 1 January 2016 and 31 December 2018 were included in the study. The direct cost of HF was estimated from the patients' healthcare resource utilisation throughout a one-year follow-up period extracted from patients' medical records. The total costs consisted of outpatient, hospitalisation, medications, laboratory tests and procedure costs, categorised according to ejection fraction (EF) and the New York Heart Association (NYHA) functional classification. RESULTS: A total of 329 patients were included in the study. The mean +/- standard deviation of total cost per HF patient per-year (PPPY) was USD 1,971 +/- USD 1,255, of which inpatient cost accounted for 74.7% of the total cost. Medication costs (42.0%) and procedure cost (40.8%) contributed to the largest proportion of outpatient and inpatient costs. HF patients with preserved EF had the highest mean total cost of PPPY, at USD 2,410 +/- USD 1,226. The mean cost PPPY of NYHA class II was USD 2,044 +/- USD 1,528, the highest among all the functional classes. Patients with underlying coronary artery disease had the highest mean total cost, at USD 2,438 +/- USD 1,456, compared to other comorbidities. HF patients receiving angiotensin-receptor neprilysin-inhibitor (ARNi) had significantly higher total cost of HF PPPY in comparison to patients without ARNi consumption (USD 2,439 vs. USD 1,933, p < 0.001). Hospitalisation, percutaneous coronary intervention, coronary angiogram, and comorbidities were the cost predictors of HF. CONCLUSION: Inpatient cost was the main driver of healthcare cost for HF. Efficient strategies for preventing HF-related hospitalisation and improving HF management may potentially reduce the healthcare cost for HF treatment in Malaysia. CI - Copyright (c) 2022 Ong, Low, Yew, Yen, Abdul Kader, Liew and Abdul Ghapar. FAU - Ong, Siew Chin AU - Ong SC AD - Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinag, Malaysia. FAU - Low, Joo Zheng AU - Low JZ AD - Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinag, Malaysia. AD - Hospital Sultan Ismail Petra, Ministry of Health, Kelantan, Malaysia. FAU - Yew, Wing Yee AU - Yew WY AD - Hospital Queen Elizabeth, Ministry of Health, Sabah, Malaysia. FAU - Yen, Chia How AU - Yen CH AD - Institute for Clinical Research, National Institute of Health, Ministry of Health, Selangor, Malaysia. AD - Clinical Research Centre Hospital Queen Elizabeth II, Ministry of Health, Sabah, Malaysia. FAU - Abdul Kader, Muhamad Ali S K AU - Abdul Kader MASK AD - Hospital Pulau Pinang, Ministry of Health, Pulau Pinang, Malaysia. FAU - Liew, Houng Bang AU - Liew HB AD - Hospital Queen Elizabeth II, Ministry of Health, Sabah, Malaysia. FAU - Abdul Ghapar, Abdul Kahar AU - Abdul Ghapar AK AD - Hospital Serdang, Ministry of Health, Selangor, Malaysia. LA - eng PT - Journal Article DEP - 20221102 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9666382 OTO - NOTNLM OT - cost OT - cost analysis OT - cost-of-illness OT - economic burden OT - heart failure COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/11/22 06:00 MHDA- 2022/11/22 06:01 PMCR- 2022/01/01 CRDT- 2022/11/21 04:32 PHST- 2022/06/17 00:00 [received] PHST- 2022/10/17 00:00 [accepted] PHST- 2022/11/21 04:32 [entrez] PHST- 2022/11/22 06:00 [pubmed] PHST- 2022/11/22 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.971592 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Nov 2;9:971592. doi: 10.3389/fcvm.2022.971592. eCollection 2022.