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The Economic Burden of Chronic Cardiovascular Disease for Major Insurers

RTI International in Research Triangle Park, North Carolina

Eric A. Finkelstein, PhD

Public Health Economics group at RTI International in Research Triangle Park, North Carolina

Isaac A. Nwaise, MA

Northrop Grumman in Atlanta, Georgia

Florence K. Tangka, PhD

Division of Cancer Prevention, Centers for Disease Control and Prevention, in Atlanta, Georgia

Diane Orenstein, PhD

Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, in Atlanta, Georgia, diane.orenstein{at}cdc.hhs.gov

Accounting models provide less precise estimates of disease burden than do econometric models. The authors seek to improve these estimates for cardiovascular disease using a nationally representative survey and econometric modeling to isolate the proportion of medical expenditures attributable to four chronic cardiovascular diseases: stroke, hypertension, congestive heart failure, and other heart diseases. Approximately 17% of all medical expenditures, or $149 billion annually, and nearly 30% of Medicare expenditures are attributable to these diseases. Of the four diseases, hypertension accounts for the largest share of prescription expenditures across payers and the largest share of all Medicaid expenditures. The large number of people with cardiovascular disease who are eligible for both Medicare and Medicaid could lead to large shifts in the burden to these payers as prescription drug coverage is included in Medicare. A societal perspective is important when describing the economic burden of cardiovascular disease.

Key Words: medical expenditures • econometric model • cost estimation • cardiovascular disease • stroke • hypertension • congestive heart failure • heart diseases • Medicaid • Medicare • insurer

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