Author + information
- Received July 27, 2017
- Revision received December 12, 2017
- Accepted December 13, 2017
- Published online March 7, 2018.
- Karen E. Van Nuys, PhDa,∗ (, )
- Zhiwen Xie, MAa,
- Bryan Tysinger, MPAa,
- Mark A. Hlatky, MDb and
- Dana P. Goldman, PhDa
- aLeonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California
- bStanford University School of Medicine, Stanford, California
- ↵∗Address for correspondence:
Dr. Karen Van Nuys, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, 635 Downey Way, Verna & Peter Dauterive Hall, Suite 210, Los Angeles, California 90089-3333.
Objectives The goal of this study was to illustrate the potential benefit of effective congestive heart failure (CHF) treatment in terms of improved health, greater social value, and reduced health disparities between black and white subpopulations.
Background CHF affects 5.7 million Americans, costing $32 billion annually in treatment expenditures and lost productivity. CHF also contributes to health disparities between black and white Americans: black subjects develop CHF at a younger age and are more likely to be hospitalized and die of this disease. Improved CHF treatment could generate significant health benefits and reduce health disparities.
Methods We adapted an established economic-demographic microsimulation to estimate scenarios in which a hypothetical innovation eliminates the incidence of CHF and, separately, 6 other diseases in patients 51 to 52 years of age in 2016. This cohort was followed up until death. We estimated total life years, quality-adjusted life years, and disability-free life years with and without the innovation, for the population overall and for race- and sex-defined subpopulations.
Results CHF prevalence among 65- to 70-year-olds increased from 4.3% in 2012 to 8.5% in 2030. Diagnosis with CHF coincided with significant increases in disability and medical expenditures, particularly among black subjects. Preventing CHF among those 51 to 52 years of age in 2016 would generate nearly 2.9 million additional life years, 1.1 million disability-free life years, and 2.1 million quality-adjusted life years worth $210 to $420 billion. These gains are greater among black subjects than among white subjects.
Conclusions CHF prevalence will increase substantially over the next 2 decades and will affect black Americans more than white Americans. Improved CHF treatment could generate significant social value and reduce existing health disparities.
Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number P30AG043073 and by the Schaeffer Center for Health Policy and Economics at the University of Southern California. Additional support was provided by Novartis, Inc. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors. Dr. Goldman is a co-founder of Precision Health Economics and holds equity in its parent company. Dr. Van Nuys has served as a consultant to Precision Health Economics. Dr. Hlatky has received consulting fees from Acumen, Blue Cross Blue Shield Association, and the George Institute; and research grants from HeartFlow, Milestone Pharmaceuticals, Sanofi, and St. Jude Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 27, 2017.
- Revision received December 12, 2017.
- Accepted December 13, 2017.
- 2018 American College of Cardiology Foundation
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