OBJECTIVES: Given that most cost-of-illness studies are prevalence-based, there is little information on the lifetime healthcare costs of heart failure (HF) from diagnosis to death (incidence-based). This study uses linked administrative data to assess the lifetime healthcare costs of HF in the Dutch population of patients with HF. In particular, we investigated the relationship between healthcare costs and time to death and between healthcare costs and time since diagnosis.

METHODS: Newly diagnosed HF patients were identified from the administrative data of the Dutch population from the National Basic Register of Hospital Care and defined as patients who had not been admitted due to HF in the two years prior to their 2013 HF admission index. Lifetime healthcare costs have been estimated by combining patient data with mortality rates and (long-term) care use from Statistics Netherlands from 2011 to 2020.

RESULTS: We identified 24,046 unique patients, of which 18,916 died during follow-up. This group lived an average of 2.5 years and had an average of 5.4 hospital admissions. The lifetime cost per patient was €64,044, of which 60% was attributable to hospital costs and 30% to long-term care costs. Hospitalization and long-term care costs showed substantial increases as individuals approached death. Hospitalization costs rose from €4,866 four years before death to €17,668 one year before death. Long-term care costs rose from €2,536 four years before death to €22,286 one year before death. Hospitalization costs were €8,403 four years after diagnosis and €17,466 in the year of diagnosis. Long-term costs were €9,083 in the first two years after diagnosis but increased to €16,203 after six years.

CONCLUSIONS: The healthcare costs of HF increase with age, with the costs in the last year of life being 3.25 times higher than the average costs in the other years of life with HF.