OBJECTIVES:

In the absence of local real life mortality & morbidity and costs data associated with CHF in the Czech Republic, we aimed to describe CHF socio-economic disease burden (DB) from health care system perspective. This is necessary to be clarified in order to better understand added value of novel therapies.

METHODS:

We mined data from existing Acute Heart Failure Database (AHEAD). Subgroup of 1274 patients hospitalized in 2 centers in Moravia for acute heart failure (AHF) and afterwards developing CHF that are included in the AHEAD (local registry including patients after AHF hospitalization = index hospitalization), were followed up for 2 years and frequency of hospitalization and their mortality rate were assessed. Six endpoints were determined – AHF re-hospitalization, acute coronary syndrome hospitalization, cardiovascular (CV) hospitalization, non-CV hospitalization, hospitalization for any cause and overall mortality. Patients were classified into 4 groups based on outcome they reached – no death and no hospitalization; death without hospitalization; hospitalization but no death; hospitalization and death. Each hospitalization event was assigned with particular costs based on DRG tariff, just in-patient costs were descried.

RESULTS:

Czech patients were generally older than patients in RCTs (median age 75.9 years). After 24 months of follow-up, 36 % of patients died and 68.2 % of patients had at least one hospitalization/ died. Average number of hospitalizations was 1.2 (SD 1.6). The average annual CHF in-patient costs are 2.8k USD (77% of costs attributed to CV hospitalization). Based on 1.6% CHF prevalence, there is 5.3% of all direct health care spending in the Czech represented by hospitalization of CHF patients.

CONCLUSIONS:

Patients in real life are in significantly higher risk of hospitalization and all-cause mortality (by approx. 80 %), compared to RCT population. Overall HF DB in the Czech is notable and compared to published evidence it is greatly underestimated.