Objectives There are limited data on the humanistic and economic burden of heart failure with preserved ejection fraction (HFpEF) in China. Therefore, we aimed to collect real-world data on the resource utilisation, treatment patterns and costs of managing HFpEF in China.
Methods A retrospective chart review was conducted in 10 hospitals in 5 regions of China (Beijing, Shanghai, Chengdu, Guangzhou, and Wuhan) to identify patients hospitalised for heart failure (HF) between 2005 and 2008. Charts were reviewed for healthcare treatment between 2000 and 2011 and data collected from the index HF hospitalisation to last date of entry or death.
Results This study included 805 patients, of which 282 had HFpEF. Mean follow-up was 2.8 years. For patients with HFpEF, the mean age was 65 years and 57% were male. There was a high prevalence of hypertension (73%), and 31, 40, 21 and 8% of patients had New York Heart Association (NYHA) class I, II, III and IV HF, respectively, at index hospitalisation. For patients with HFpEF, 34% were rehospitalized following the index hospitalisation and the mean number of hospitalizations was 2.8. The mean length of stay for the index hospitalisation was 12 days, increasing to 18, 19 and 16 days for the second, third and fourth hospitalizations, respectively. The total cost of index hospitalisation was 27066 (US$ 3998), 18269 (US$ 2698) and 1039 (US$ 153) Renminbi for patients with HFpEF in NYHA class II, III and IV, respectively (exchange rate was 1 Renminbi = 0.1477 US Dollars based on 2010 data). A substantial proportion of the costs during the index hospitalisation were due to cardiac surgeries/procedures, contributing 25806 (US$ 3812), 16778 (US$ 2478) and 412 (US$ 61) Renminbi for patients with HFpEF in NYHA class II, III and IV, respectively. Although outpatient services were widely utilised by patients with HFpEF, the mean number of outpatient and cardiology visits decreased each year post-index hospitalisation for all NYHA classes. In the first year after the index hospitalisation, the most commonly prescribed drugs were Ca2+ channel blockers (34%), β-blockers (29%), angiotensin converting enzyme inhibitors (28%), statins (28%) and angiotensin receptor blockers (20%), but drug treatment decreased substantially to less than 5% for each drug class in the following 2 years.
Conclusions These real-world data demonstrate that HFpEF is a resource intensive condition that imposes a significant humanistic and economic burden in China. The cost of index hospitalisation was greatest for patients with HFpEF in NYHA class II due to the high cost of cardiac surgeries/procedures performed in this population.