The Burden of Heart Failure in the US: Medical Costs and Health-Related Quality of Life

BackgroundTo quantify the economic burden and health-related quality of life (HRQoL) impact of heart failure (HF) in the U.S., stratified by age and diabetes status. MethodsUsing a micro-level, bottom-up prevalence-based approach from a payer perspective, we analyzed healthcare costs from the Optum Research Database (ORD). HF prevalence and HRQoL via EuroQol 5-Dimensions and Healthy Days instruments were estimated using National Health and Nutrition Examination Survey (NHANES). ResultsThe average annual direct healthcare cost per HF patient was approximately $31,464 at baseline, rising to $45,893 in the first-year post-diagnosis before stabilizing around $37,500 annually. Inpatient care accounted for the largest cost share. Extrapolating at the national level, expenditures exceeded $227 billion at baseline and peaked at $332 billion in the year following a HF hospitalization. Individuals without diabetes had the highest quality-adjusted life years (QALYs) and lowest costs, while type 1 diabetes patients had the lowest QALYs and highest costs. Type 2 diabetes patients represented the largest subgroup with intermediate QALYs but substantial costs. ConclusionsHF imposes a significant, sustained economic and quality-of-life burden, highlighting the need for targeted management strategies, especially for older adults and those with diabetes.