Estimating the Economic Burden of Atrial Fibrillation in Selected Developing Countries

Objectives

Atrial fibrillation (AF) is a chronic, progressive disease characterized by uncoordinated atrial activation involving rapid, irregular heartbeats (Fuster et al. 2006). AF patients are likely to have co-morbidities such as congestive heart failure (CHF) and stroke (Lee et al. 2008). The prevalence of AF in adults is <1% in adults <55 years, but increases to as much as 10% by age 80 (Go et al. 2001). The purpose of this study was to estimate the economic burden of AF in selected developing countries based on prevalence and direct health care costs.

Methods

The economic burdens of AF in Brazil, China, India, Russia, and Turkey were calculated based on prevalence rates identified via a literature search. Annual probabilities for health care interventions and related costs (e.g.: management of AF, stroke and CHF), and associated disability costs were included in the model. The adult population was adjusted for the percentage of the population who had access to health care. If cost data were unavailable, costs were imputed based on the ratio of per capita health expenditures between the United States and country of interest. Sensitivity analysis was performed for the health care accessible population.

Results

The prevalence of AF in adults in the countries studied was: 226,000 in Turkey; 430,000 in Brazil; 497,000 in Russia; 778,000 in India; and 1.8 million in China. The estimated annual economic burden of AF was: 159 million in Turkey; 412 million in Brazil; 5.7 billion in Russia; 1.25 billion in India; and 2.5 billion in China (2010 local currencies). Sensitivity analysis revealed that the results could be substantially higher.

Conclusions

The economic burden of AF in developing countries is potentially substantial given the large populations in these countries. Proper management of AF is becoming increasingly important in countries where access to health care has constantly been improved.