OBJECTIVES: Estimation of the economic burden of heart failure (HF) through a complete evaluation is essential for improved treatment planning in the future. This estimation also helps in reimbursement decisions for newer HF treatments. This study aims to estimate the cost of HF treatment in Malaysia. The estimation was from the Ministry of Health’s perspective, categorised according to ejection fraction (EF) and the New York Heart Association (NYHA) functional classification.

METHODS: A prevalence-based, bottom-up cost analysis study was conducted in three tertiary hospitals in Malaysia. Chronic HF patients who received treatment between 1 January 2016 and 31 December 2018 were included in the study. The direct cost of HF was estimated from the utilisation of healthcare resources by patients throughout a one-year follow-up of patient medical records.

RESULTS: A total of 329 patients were included in the study. The mean ± standard deviation of total cost per HF patient per-year (PPPY) was USD 1956 ± USD 1251, of which inpatient cost accounted for 74.5% of the total cost. Medication costs (42.0%) and procedure cost (41.2%) contributed to the largest proportion of outpatient and inpatient costs. HF patients with preserved EF had the highest mean total cost of PPPY, at USD 2512 ± USD 820. The mean cost PPPY of NYHA class II was USD 2030 ± USD 1525, the highest among all the functional classes. Patients with underlying coronary artery disease had the highest mean total cost, at USD 2423 ± USD 1452, compared to other comorbidities. Hospitalisation, percutaneous coronary intervention, coronary angiogram, and comorbidities were the cost predictors of HF.

CONCLUSION: Inpatient cost was the driver of healthcare cost for HF. Therapeutic strategies such as the prevention of HF-related hospitalisation and mitigation of disease progression are vital for reducing costs. This can be achieved by targeting HF risk factors.