Economic evaluation and healthcare resource utilization in heart transplant in adults with congenital heart disease

Purpose of review This review is timely and relevant because the population of adults with congenital heart disease (ACHD) in the United States continues to grow, and as more individuals survive into adulthood, heart failure has become the leading cause of morbidity and mortality in this population. There is a growing need to understand the economic impact of healthcare utilization and financial burden for patients with ACHD and end-stage heart failure. Recent findings Recent literature highlights that adults with complex congenital heart disease face disproportionately high financial burden with lifetime direct and indirect costs reaching up to $3.35 million per patient. These costs include frequent hospitalizations, surgeries, diagnostic testing, and ongoing medical care, as well as lost income for patients and families. The cost burden increases further towards the end of life, and ACHD patients with heart failure experience longer hospital stays, and higher healthcare costs compared to non-ACHD populations. Early referrals can mitigate some of the increasing cost by implementing multidisciplinary care strategies and timely interventions to potentially improve the trajectory of ACHD patients with heart failure. Summary The findings underscore the need for early referral to specialized, high-volume ACHD and heart transplant centers and the development of multidisciplinary care pathways to improve outcomes and reduce costs for ACHD patients with advanced heart failure.