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.