Costs of management of patients with coronary artery disease in Poland: the multicenter RECENT study

INTRODUCTION Treatment of coronary artery disease (CAD) generates the major part of public health expenditure in the developed countries.
OBJECTIVES The aim of the study was to estimate costs associated with the diagnosis and treatment of patients with CAD in Poland.
PATIENTS AND METHODS Costs were estimated in a representative sample of 2593 patients with CAD receiving general practitioner (n = 1977) or specialist care (n = 616) in 2005 (the multicenter RECENT study). Data from the National Health Fund, Social Insurance Institution, Central Statistical Office, and current literature were used.
RESULTS The total annual cost of CAD reached €2254.17 per patient, with 48% accounting for direct medical costs (drugs, medical consultations, laboratory tests, diagnostic procedures, invasive treatment, hospitalizations, emergency care) and 52% for indirect costs (related to absence at work and disability). Eighty‑one percent of total direct medical costs were covered by the public payer (including 30% of pharmacological treatment costs). Direct medical costs covered by the public payer were higher in men and in patients with more severe angina symptoms (both P <0.05). In the model based on the lowest prevalence of CAD (estimated based on the real population of patients treated in 2005), direct medical costs covered by the public payer reached €617.6 million, i.e., around 7% of the total public health expenditure in Poland in 2005.
CONCLUSIONS Modern management of CAD imposes enormous economic burden on the public health system in Poland. There is a need to develop and implement strategies that would optimize health care costs associated with the treatment of CAD.