OBJECTIVES: To estimate the medical costs associated with non-fatal myocardial infarction (MI) and ischemic stroke (IS).

METHODS: Patients with their first MI or IS (without diagnosis for three years) that occurred between 2011 and 2015 were identified using Taiwan’s National Health Insurance Research Database (2008-2017). Patients were followed for two years for recurrent events. Acute cost was estimated for both first and recurrent events. After the first event, the annual total costs (inpatient, outpatient, and emergency room visits) were compared with annual costs in the baseline prior to the first event to determine the incremental costs. Costs are presented as median (Q1-Q3) and in 2017 US dollar ($).

RESULTS: A total of 47,721 patients with first MI and 93,331 with first IS were identified. One-year recurrent rates were 4.32 per 100 person-years for MI and 5.67 per 100 person-years for IS. Two-year recurrent rates were 3.18 per 100 person-years for MI and 4.46 per 100 person-years for IS. The acute event cost was $4,684 (3,587-5,940) for first MI, $4,288 (2,556-6,067) for recurrent MI, $1,092 (718-2,054) for first IS, and $1,151 (714-2,253) for recurrent IS. The total annual costs in the first year and second year were $2,404 (1,431-5,903) and $1,478 (810-3,377) for MI, and $2,151 (1,065-5,210) and $1,642 (814-3,752) for IS, respectively. The incremental costs in the first year was $1,466 (711-4,432) for MI and $1,137 (325-3,701) for IS.

CONCLUSIONS: Non-fatal MI and IS continue to impose a great economic burden on Taiwan’s health care system, and more efforts should be made to improve the risk factor management for secondary disease prevention. The cost of MI was higher than IS for both first and recurrent events. Future analysis would be needed to assess the impact of changes in reimbursement policy, such as mechanical thrombectomy, on cost estimates.