Heart failure in the Veneto region of Italy: analysis of therapeutic pathways and the utilization of healthcare resources

Expert Rev Pharmacoecon Outcomes Res. 2020 Oct;20(5):499-505. doi: 10.1080/14737167.2020.1718494. Epub 2020 Jan 23.

Abstract

Objectives: Aim of the study was to describe the use and pharmacoutilization profiles of recommended drugs for HF patients, hospital re-admission rates, mortality rates and determine healthcare resource consumption and related costs for HF patients in an Italian region. Methods: We retrospectively analyzed data from the administrative database and included adult patients who were discharged alive with a primary or secondary HF diagnosis between 1 January 2010 and 31 December 2015. We assessed data on HF-related drug prescriptions at discharge and during a 12-month follow-up period, as well as treatment adherence and treatment modification. All-cause mortality, hospital HF re-admission, and mean direct cost per patient were also analyzed during the follow-up period. Results: A total of 69,164 patients were included. One in ten patients had discontinued all treatment initially prescribed by the end of follow-up. In total, 25.9% of patients were re-hospitalized with an HF diagnosis during the follow-up period; the mortality rate at 12 months was 24.3%. The mean annual cost per patient was €6,303.7, with nearly three-fourths attributable to hospitalizations. Conclusions: In our study, we observed an under-prescription of recommended drugs for the treatment of HF. Moreover, one out of four HF patients were re-hospitalized for HF-related causes and the healthcare costs related to hospitalization accounted for the great majority of the total healthcare resource costs.

Keywords: Healthcare costs; heart failure; pharmacoutilization profile; real-world data.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Health Resources / statistics & numerical data
  • Heart Failure / drug therapy*
  • Heart Failure / economics
  • Heart Failure / mortality
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Italy
  • Male
  • Medication Adherence
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies