OBJECTIVES: Heart failure (HF) significantly destabilize concomitant disease states. Bronchial obstructive diseases (BOD): asthma (A), COPD and asthma-COPD-overlap (ACO) can be predictors of HF. Comorbidity generates new costs that complicate healthcare system budget planning. The aim of the study was to determine the economic consequences of HF adult patients with BOD from the Russian healthcare system's perspective.

METHODS: A systematic search was performed by two authors independently of each other in Medline and Tripdatabase medical databases. Using the bottom-up method, direct and indirect costs (associated with HF ambulance calls and hospitalizations, lost working capacity) were calculated. The cost analysis was performed according to a standardized methodology of the Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation using Federal regulatory documents (Federal program of Government guarantees of medical care). Costs in rubles were converted into euros at the exchange rate of the Central Bank of Russia.

RESULTS: The costs of ambulance calling and hospitalization amounted € 631.9 per case. The average nominal salary per day was € 18 according to the Federal Statistics Agency. The probability of hospitalization was obtained from the work of Truls S.I. and colleagues and extrapolated to the study population. The study included patients with a risk of hospitalization for HF with the following phenotypes of BOD: BA with early-onset, BA with late-onset, COPD with FEV1≥50% of predicted value, COPD with FEV1 <50% of predicted value and four variants of ACO. The average duration of hospitalization lasted 9 days.

CONCLUSIONS: Associated with HF additional costs ranged from € 1,274,131.2 to € 3,409,881.5 per each thousand people. Maximal costs for HF was linked to ACO (late-onset asthma and COPD) and severe COPD. Obtained data must be taken into account when planning the budget of the healthcare system for bronchial obstructive diseases.