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Researchers at Oxford Population Health’s Health Economics Research Centre have found that cardiovascular disease cost the European Union (EU) economy €282 billion in 2021. The results of their study were presented at the European Society of Cardiology (ESC) Congress 2023 in Amsterdam.

Cardiovascular disease is the most common cause of ill health and premature death in adults globally. The most common types of cardiovascular disease are coronary heart disease and cerebrovascular diseases, such as strokes. Together these two types of disease were responsible for killing 925,666 (55%) of the 1.7 million EU citizens who died from cardiovascular disease in 2021 and published in the European Heart Journal.

Cardiovascular disease also often leads to disability, premature retirement, and absenteeism, which can result in reduced productivity and economic output. This is the first study since 2017 to evaluate the costs of cardiovascular disease in the EU and is the first to be able to accurately estimate health and social care costs, informal care costs, and productivity loss.

Key findings:

  • Cardiovascular disease accounted for ten million hospital admissions in the EU, representing 22 admissions per 1,000 people. For every 1,000 people, there were 656 visits to GPs and 356 appointments with outpatient consultants;
  • Hospital care accounted for 60% of cardiovascular disease-related healthcare costs, followed by drug expenditure, outpatient care, primary care, and emergency care;
  • Cardiovascular disease cost the EU health and social care systems alone approximately €155 billion, which is 11% of total health and social care spending. The amount spent on health and social care varied between countries, from €154 per person in Croatia to €505 per person in Austria;
  • 7.5 billion hours of unpaid care by relatives or friends were provided to people whose care needs could be directly attributable to cardiovascular disease, representing a cost of €79 billion across the EU;
  • The 1.7 million deaths as a result of cardiovascular disease in 2021 represents 1.3 million working years lost and around €32 billion in lost productivity. Ill health as a result of cardiovascular disease resulted in the loss of 256 million working days, representing an estimated cost of €15 billion;
  • Overall, cardiovascular disease cost the EU economy €282 billion in 2021. 46% of these costs were due to health care, 28% due to informal care, and 9% due to social care. 17% of these costs were due to productivity losses. This represents an average cost of €620 per EU citizen.

Dr Ramon Luengo-Fernandez, Associate Professor at Oxford Population Health’s Health Economics Research Centre and lead author of the study, said ‘Previous cross-EU estimates of cost have relied heavily on assumptions to apportion overall totals of non-hospital care rather than individual patient-level data and have omitted important costs such as long-term social care.

‘Our study highlights the significant consequences of cardiovascular disease on various sectors of the European economy. It both emphasises the magnitude of the economic burden but also provides valuable insights for public health decision makers. Our study underscores the need to address variations in healthcare provision and improve accessibility to care across EU countries’

ESC Board member and study author Professor Victor Aboyans of Limoges University, France, said ‘This study underscores the urgent need to act collectively on the European scale to better combat the cardiovascular risk of European citizens, in particular through regulations for better cardiovascular prevention and investment in research. By choosing not to invest in cardiovascular disease, we are simply deferring the cost. These data force us to ask the question: do we invest in cardiovascular health today or be forced to pay more at a later stage?’

The researchers used the same methodological framework to obtain data for, and value the cardiovascular disease related resource use for each of the 27 EU member states in 2021. They used data from national and international sources, including the Statistical Office of the European Communities (EUROSTAT), the Organisation for Economic Co-Operation and Development (OECD), the ESC Atlas of Cardiology, national ministries of health, and statistical institutes. Country-specific data on the number of cases of cardiovascular disease, coronary heart disease, and cerebrovascular disease were obtained from the Global Burden of Disease study. The data were supplemented with analysis of individual patient-level data from the Survey of Health, Ageing and Retirement in Europe (SHARE).

All costs are expressed in 2021 prices, have been converted to euros where applicable, and adjusted to account for price differences between countries.