Heart failure in the Veneto region of Italy: analysis of therapeutic pathways and the utilization of healthcare resources

ABSTRACT

Objectives: Aim of the study was to describe the use and pharmacoutilization profiles of recommended drugs for HF patients, hospital re-admission rates, mortality rates and determine healthcare resource consumption and related costs for HF patients in an Italian region.

Methods: We retrospectively analyzed data from the administrative database and included adult patients who were discharged alive with a primary or secondary HF diagnosis between 1 January 2010 and 31 December 2015. We assessed data on HF-related drug prescriptions at discharge and during a 12-month follow-up period, as well as treatment adherence and treatment modification. All-cause mortality, hospital HF re-admission, and mean direct cost per patient were also analyzed during the follow-up period.

Results: A total of 69,164 patients were included. One in ten patients had discontinued all treatment initially prescribed by the end of follow-up. In total, 25.9% of patients were re-hospitalized with an HF diagnosis during the follow-up period; the mortality rate at 12 months was 24.3%. The mean annual cost per patient was €6,303.7, with nearly three-fourths attributable to hospitalizations.

Conclusions: In our study, we observed an under-prescription of recommended drugs for the treatment of HF. Moreover, one out of four HF patients were re-hospitalized for HF-related causes and the healthcare costs related to hospitalization accounted for the great majority of the total healthcare resource costs.

KEYWORDS:

• Healthcare costs
• heart failure
• pharmacoutilization profile
• real-world data

Article Highlights

• The study describes a cohort of patients discharged with a diagnosis of heart failure from a north-eastern Italian region in Italy in a real-world setting.

• In the cohort investigated, drugs recommended for heart failure were under-prescribed.

• The analysis of pharmacoutilization reveals that one out of ten patients discontinued the treatments prescribed after hospitalization discharge and almost half of the patients required a change of therapy.

• Around one-fourth of the population included had a re-hospitalization related to heart failure.

• The annual mean expenditure per patient was mainly driven by hospitalization-related costs.

Declaration of interest

D Ritrovato and C Pitotti are employees of Novartis, Italy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was sponsored by Novartis.