OBJECTIVES: Atherosclerotic Cardiovascular Disease (ASCVD) is a global public health concern. Insights into the economic burden of managing ASCVD based on risk profiles, could contribute to improve resource allocation and management strategies. This study aims to estimate the healthcare resource utilization (HCRU) and costs stratified by cardiovascular disease (CVD) risk categories using real-world evidence, in the population of the North of Portugal.

METHODS: This was a multicentre, retrospective observational study, using data from Electronic Health Records between 2017 and 2021. Patients aged ≥40 years, and with at least 1 general practitioner (GP) visit in the 3 years before 31st of December 2019, were included. CVD risk categories were determined based on 2021 ESC prevention guidelines. HCRU was determined for hospitalizations, outpatient and emergency room visits as well as GP appointments. Total costs and costs per patient were calculated based on the reference cost of the Portuguese legislation.

RESULTS: The analysis of 3 122 695 episodes , revealed consistent HCRU and costs across the five years. Very high-risk patients (29.8%) showed higher HCRU, particularly in hospital admissions. Costs tended to rise with higher CVD risk level. Very high-risk patients with ASCVD (11.0%) had higher costs for hospital admissions, while low-to-moderate risk patients (44.5%) had higher costs for GP visits. Very high-risk patients with prior ASCVD represent the highest costs per patient per episode across all types of healthcare settings (from 115€ in emergency visits to 2 673€ in hospitalizations), followed by very high-risk patients without prior ASCVD.

CONCLUSIONS: This study revealed a substantial HCRU by patients with very high CVD risk, particularly those with prior ASCVD. Moreover, patients with ASCVD risk-equilvalents also contribute considerably, emphasizing the importance of risk assessment and preventive measures in cost-effective management of these patients.