OBJECTIVES: To estimate the direct and indirect costs associated to atherosclerosis in Portugal for 2016 considering a societal perspective.

METHODS: A prevalence-based approach was adopted to estimate costs associated to atherosclerosis. Prevalence of the different atherosclerosis clinical presentations (acute myocardial infarction, stable angina, ischemic heart failure [HF], ischaemic cerebrovascular disease and peripheral artery disease [PAD]) were estimated using the microdada of the 2014 National Health Survey, the microdata of a national community-based epidemiological survey on HF prevalence and a national PAD prevalence study. Primary care costs were estimated using a comprehensive administrative database, with records of medical resource use for 318,692 patients with atherosclerosis in 2016. Resource use in hospital ambulatory care including emergency episodes was estimated based on experts’ opinion. Inpatient resource use was estimated using national DRG microdata. Unit costs were based on the official NHS tariffs. The indirect costs associated to patients’ absenteeism and early exit from the labour force were estimated using the Human Capital approach and based on national sources. The primary care national database was used to estimate the overlap of different clinical presentations of atherosclerosis.

RESULTS: The estimated direct cost attributable to atherosclerosis in 2016 was around € 1,100 M (€199 M for inpatient hospital care and € 915 M for ambulatory care). The indirect costs generated by the production lost due to disability must also be taken into account and they added up to € 811 M. The overall costs of disease were therefore estimated at € 1,924 M, about 1% of Portuguese GDP and 11% of all Portuguese health spending in 2016.

CONCLUSIONS: Atherosclerosis is a costly condition and should receive adequate attention from the Portuguese health policy makers.