Systematic literature review on the economic, humanistic, and societal burden of heart failure in children and adolescents

ABSTRACT

Introduction: Unlike the adult heart failure (HF) patient population, there is scarce information on the overall burden of HF in the pediatric population across geographies and within different age groups.

Areas covered: A systematic review aims to describe and quantify the economic, humanistic, and societal burden of pediatric (age <18 years) HF on patients and caregivers. Eighteen published studies over a period of 10 years (1 January 2006–20 May 2016) were identified through Embase, Medline, Cochrane Library and selected congresses. Studies from the US reported higher HF-related hospitalization-rates in infants aged <1 year (49.3%-63.9%) versus children aged 1–12 years (18.7%-30.9%) in HF diagnosed patients. Across the studies, the average length of hospital stay was 15 days, increasing to 26 days for infants. Average annual hospital charges were higher for infants (US$176,000) versus children aged 1–10 years (US$132,000) in the US. In Germany, diagnosis-related group (DRG)-based hospital-allowances per HF-case increased from €3,498 in 1995 to €4,250 in 2009.

Expert opinion: To our knowledge, this is the first systematic review, which provides valuable insights into the burden of HF in children and adolescents, and strengthens current knowledge of pediatric HF. However, there is a need for larger population-based studies with wider geographical coverage.

KEYWORDS:

• Heart failure
• pediatric
• economic
• burden
• hospitalization
• mortality

Article Highlights

• The burden of Heart Failure (HF) in pediatric <18 years age is not well understood.

• The overall burden of pediatric HF, including the economic, humanistic and societal burden, are lacking.

• In pediatric HF, there is a significant heterogeneity in terms of mechanisms of the disease, clinical presentation, and primary and secondary etiologies.

• No established diagnostic criteria and guidelines exist for the management of pediatric HF as compared to that of adults.

• To date, no systematic review has been available to estimate the burden of pediatric HF.

• Measuring the burden of pediatric HF is complex and involves the evaluation of economic, humanistic (patients and caregivers), and societal aspects.

  • The small number of studies, heterogeneity, and limited geographical coverage indicate a need for further research in this field.

  • This box summarizes the key points contained in the article.

Declaration of interest

M Burch is a consultant to Novartis and received personal fees from Novartis. T Jaecklin was an employee of Novartis during the conduct of this study and currently is an employee of Mirum Pharmaceuticals AG, Basel. RE Shaddy and JW Rossano are consultants to Novartis. TK Nallagangula, E Nic Lochlainn, T Severin, L Thakur, AT George and S Solar-Yohay are all employees of Novartis. 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.

Supplemental material

Supplemental data for this article can be accessed here.

Additional information

Funding

This study was funded by Novartis Pharma AG, Basel.