Direct medical cost of newly diagnosed stable coronary artery disease in Hong Kong

BACKGROUND: Stable coronary artery disease (CAD) affects approximately 7% of the population of Hong Kong and is associated with substantial healthcare costs. OBJECTIVE: We aimed to evaluate the first-year direct medical cost for a patient with newly diagnosed stable CAD at a tertiary care public hospital in Hong Kong and to identify CAD-related resource consumption pattern among different patient subgroups. METHODS: 89 consecutive patients with newly diagnosed stable CAD at our institution from January 2007 to December 2009 were retrospectively analysed. Direct medical costs including hospitalisation, clinic visits, diagnostic tests, laboratory tests, invasive procedures and medications were calculated for 1 year after diagnosis. Mann-Whitney tests were performed to compare median costs in patients with and without hypertension, diabetes mellitus and hyperlipidaemia, and in patients undergoing coronary intervention and those who were not. RESULTS: The mean first-year total direct medical cost of newly diagnosed stable CAD per patient was US$11 477. Hospitalisation was the dominant cost item accounting for 29.2% of the total cost. The total cost for patients who underwent invasive coronary procedure was higher than those treated medically alone (US$14 787 vs US$6121, p<0.001). Hyperlipidaemia was associated with higher incremental costs than hypertension and diabetes mellitus (p<0.001). (1US$=7.8HK$). CONCLUSIONS: Huge healthcare expenses are incurred in the first year of stable CAD diagnosis from the perspective of the local public healthcare system. Healthcare costs are highest among patients with hyperlipidaemia and those undergoing invasive coronary procedures (even discounting costs for procedural consumables). Strategies for cost saving and preventive measures should be implemented to lower healthcare expenditure associated with CAD.