OBJECTIVES: Cardiovascular diseases (CVD) impose a significant economic burden on individuals and society in Indonesia, accounting for approximately one-third of all deaths. This study aims to describe the economic burden of CVD using claims data from referral health facilities under BPJS Kesehatan across Indonesia.

METHODS: This nationwide, population-based cohort study utilized the National Health Insurance System managed by BPJS Kesehatan. The study identified patients of all age groups with an inpatient and/or outpatient diagnosis of CVD, specified by ICD-10 codes as a main diagnosis, in 2021–2022. The claims data were analyzed descriptively and differentiated by age, gender, region, and type of CVD, including hypertensive heart disease, myocardial infarction, ischemic heart disease, stroke, and others. Healthcare costs for CVD included direct medical costs for hospitalization, outpatient care, and prescription drugs.

RESULTS:: A total of 119,604 CVD claims from 2021-2022 were included. The highest prevalence was observed in the age group 51-70 years (66%), with 54% being male. The majority of patients were from Java Island (62%). Ischemic heart disease, hypertensive heart disease, and stroke were the most common diagnoses, accounting for 34%, 33% and 21%, respectively. Total healthcare costs for CVD patients increased from IDR 34,413,317 billion (US$ 2,093,064) in 2021 to IDR 42,901,316 billion (US$ 2,609,315) in 2022, with an annual increase of 11%. Hospitalization costs were the highest, averaging IDR 26,667,874 billion (US$ 1,621,977) and accounting for 69% of the total costs. The distribution of these costs was similar across patients with mild, moderate, and severe disease severity.

CONCLUSIONS: This nationwide real-world study found that CVD has a substantial economic impact, with total healthcare costs rising by 11% from 2021 to 2022. These findings highlight the urgent need for targeted interventions to manage CVD and reduce its economic impact in Indonesia.