Table 1. Cost estimates reported in each selected study.
| First author, Year, Country | Cost estimates | ||||||
|---|---|---|---|---|---|---|---|
| Direct costs | Direct cost items | Indirect costs | Indirect cost items | Total costs | |||
| Balbay, 2019 [6], Turkey | From a total high-risk population of 1.9 million, FH group was estimated up to 205,557 adults. Annual estimation of direct health costs of $40 million for 2035. The study also reported a $265 million saving over 2015–2035 period, with lowering LDL-C intervention. | NR | Annual mean income lost due to CVD estimation of $83million for 2035. The study also reported a $427 million saving over 2015–2035 period, with lowering LDL-C intervention. | NR | Total costs will reach $123 million in 2035. A total $ 691 million saving could be supposed with lowering LDL-C intervention in 2015–2035 period | ||
| Patel, 2019 [15], US | In a cohort of 237 903 patients with hyperlipidemia (13.7% FH prevalence), comparison of annual revenue (per patient) from medical care service for years 2005–2015 between FH and non-FH: | NR | NR | NR | Total revenue (2005–2015) for FH $17,071 and non-FH $11,178 | ||
| Non-FH | FH | ||||||
| 2005 | $687 | $810 | |||||
| 2006 | $724 | $852 | |||||
| 2007 | $752 | $902 | |||||
| 2008 | $790 | $920 | |||||
| 2009 | $847 | $983 | |||||
| 2010 | $874 | $1,043 | |||||
| 2011 | $867 | $1,044 | |||||
| 2012 | $907 | $1,063 | |||||
| 2013 | $974 | $1,166 | |||||
| 2014 | $1,093 | $1,294 | |||||
| 2015 | $1,005 | $1,307 | |||||
| Bahia, 2018 [11], Brazil | Of the 245,981 CAD admissions/year in Brazil. annual mean costs for hospitalizations attributable to an underlying diagnosis of FH were estimated from $17,650,972 (with FH prevalence at 0.4%) to $31,448,466 (with FH prevalence 0.73%) | NR | NR | NR | Annual mean costs ranged from $17,650,972 to $31,448,466 | ||
| Besa-Creuz, 2018 [4], Mexico | For all subjects >18 years old with a diagnosis of familial hypercholesterolemia, annual mean costs were estimated at $259,172.90 | Annual mean costs of treatment $40,524.03; outpatient care $7,788.67; laboratory tests $2,455.46; drugs $2,453.66; hospitalizations $7,407.28; surgery $ 37,086.11; other complications and interventions $201,981.72 | NR | NR | Annual mean costs $259,172.90 | ||
| Nichols, 2018 [14], US | For 2,702 subjects aged 45 and older with ASCVD, costs per patient were: | ||||||
| High TG group—Mean annualized utilization per patient: $17,848 (95% CL, $17,224 to $18,473 | Inpatient admissions for CVD $971; Total inpatient $4,459; Emergency room $1,153; Outpatient clinic $4,377; Hospital ambulatory $1,001; Day surgery $455; Dialysis $137; Pharmaceutical dispenses $6,053 | NR | NR | High TG group—Mean annualized utilization per patient: $17,848 (95% CL, $17,224 to $18,473 | |||
| Normal TG group—Mean annualized utilization per patient: $16,884 (95% CL, $16,625 to $17,143) | Inpatient admissions for CVD $924; Total inpatient $4,287; Emergency room $1,083; Outpatient clinic $4,337; Hospital ambulatory $802; Day surgery $456; Dialysis $89; Pharmaceutical dispenses $5,868 | NR | NR | Normal TG group—Mean annualized utilization per patient: $16,884 (95% CL, $16,625 to $17,143) | |||
| Fox, 2016 [5], US | From a total of 451,450 subjects included in the study, direct incremental costs per patient categorized by CV event type, ranging from $17,903 to $65,825 in the first year of follow-up; from $474 to $19,617 in the second, and $2,598 to $26,982 in the third. | Costs for the first year after CV event were estimated for subjects with history of CV event $41,168; modified CHD cohort $ 41,648; moderate-risk cohort $ 40,500, and low-risk cohort $ 39,869 | NR | NR | In the first year of follow-up period post-CV event the direct incremental costs ranged from $17,903 to $65,825; from $474 to $19,617 in the second, and $2,598 to $26,982 in the third. | ||
| Costs for the second year after CV event were estimated for subjects with history of CV event $9,436; modified CHD cohort $8,301; moderate-risk cohort $6,622, and low-risk cohort $5,900 | |||||||
| Costs for the third year after CV event were estimated for subjects with history of CV event $11,400; modified CHD cohort $7,386; moderate-risk cohort $6,622, and low-risk cohort $4,704 | |||||||
| Henk, 2015 [13], US | In a total of 193,385 enrollees with hyperlipidemia, first year after CVE total costs per patient were: $41,937 (±72,513) | First year: Inpatient costs: $24,993; Emergency room costs: $586; Ambulatory costs $10,232 Office visit costs $2,237; Outpatient visit costs $7,995; Other medical costs $2,438; Pharmaceutical costs $3,689; | NR | NR | First year after CVE total costs: $41,937 (±72,513) | ||
| Second year total costs: $16,786 (±48,132) | Second year: Inpatient costs: $5,727; Emergency room costs: $352; Ambulatory costs $7,413; Office visit costs $2,012; Outpatient visit costs $5.40; Other medical costs $1,367; Pharmaceutical costs $3,391 | Second year total costs: $16,786 (±48,132) | |||||
| Third year total costs: $15,133 (±41,503) | Third year: Inpatient costs: $4,764; Emergency room costs: $290; Ambulatory costs $6,165; Office visit costs $1,740; Outpatient visit costs $3.94; Other medical costs $894; Pharmaceutical costs $3,645 | Third year total costs: $15,133 (±41,503) | |||||
| Dragomir, 2010 [12], Canada | In a cohort of 55,134 patients with hypercholesterolemia, for 26,585 low adherent patients, the total cost of hospitalization estimated for the follow-up period was $71.0 million, and the estimated total excess costs of hospitalization attributable to low adherence amounted to $9.5 million. For 28,549 high adherent patients, the total cost of hospitalization estimated for the follow-up period was $65.9 million, and the estimated total savings in costs of hospitalization attributable to high adherence amounted to $10.3 million | Predicted mean costs of hospitalization in hospitalized patients were $ 8,654 (8,358 to 8,944). | NR | NR | For 26,585 low adherent patients, the total cost of hospitalization estimated for the follow-up period was $71.0million, and the estimated total excess costs of hospitalization attributable to low adherence amounted to $9.5 million. For 28,549 high adherent patients, the total cost of hospitalization estimated for the follow-up period was $65.9 million, and the estimated total savings in costs of hospitalization attributable to high adherence amounted to $10.3 million | ||
ASCVD, atherosclerotic cardiovascular disease; CAD, coronary artery disease; CVD, cardiovascular disease; CVE, cardiovascular event; LDL-C, low-density lipoprotein–cholesterol; HDL-C, high-density lipoprotein–cholesterol; TG, triglyceride; FH, familial hypercholesterolemia, NR, not reported.