Economic Burden of Heart Failure in Europe: A Systematic Review of Costs and Cost-Effectiveness

Heart failure (HF) affects over 64 million individuals worldwide and is a major cause of hospitalization and mortality, particularly among older adults. In Europe, HF imposes a significant and growing economic burden. This systematic review aimed to evaluate the economic impact of HF diagnosis, treatment and management across European healthcare systems. A systematic literature search was conducted using PubMed, Cochrane Library and Econlit databases including the terms 'heart failure' AND 'costs' OR 'cost of illness' OR 'cost analysis' OR 'economic burden' OR 'cost effectiveness' OR 'primary care' OR 'secondary care'. Studies published between January 2000 and January 2024 were included. A total of 49 studies were included: 17 on resource use, 11 on costs, 15 on resource use and costs, 1 on costs and cost-effectiveness, and 5 on resource use, costs and cost-effectiveness. Hospitalizations and medication use were the most frequently reported resource parameters. Annual HF-related costs varied widely across countries, ranging from €613 to €22,647 per patient. Hospitalizations represented the primary cost driver, accounting for 15% to 92% of total HF costs. Cost-reduction strategies included multidisciplinary care, telemonitoring and pharmacologic interventions. Several disease management programmes reduced hospital admissions and emergency visits. Cost-effectiveness analyses supported the use of certain HF therapies, with incremental cost-effectiveness ratios ranging from €1490 to €9406 per QALY gained. F imposes a substantial economic burden in Europe, largely driven by hospitalizations. Cost-effective interventions such as remote monitoring and integrated care programmes can reduce this burden. Broader adoption of these strategies may improve outcomes and optimize resource allocation across healthcare systems.

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Publication Details

Journal
ESC Heart Failure
Published
2025-11-26
DOI
https://doi.org/10.1002/ehf2.70017
Citations
1
Primary Topic
Heart Failure Treatment and Management
Type
article
Field-Weighted Citation Impact
1.39

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article

Economic Burden of Heart Failure in Europe: A Systematic Review of Costs and Cost-Effectiveness

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ESC Heart Failure
Heart Failure Treatment and Management
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article

Economic Burden of Heart Failure in Europe: A Systematic Review of Costs and Cost-Effectiveness

Petar Vračar, Nenad Filipović, Renae J. Stefanetti, Fausto Barlocco, Annamaria Del Franco, A. Fuller, Iacopo Olivotto, Djordje G. Jakovljević, Sarah J. Charman, Marta Jiménez-Blanco Bravo, Óscar Fernández, Frans Hendrik Rutten, Aikaterini Zisaki, Jonathan Mant, Zoran Bosnić, Guy A. MacGowan, Josep Darbà, Dimitrios I. Fotiadis, David R. Sinclair, Amy Groenewegen, Prithwish Banerjee, A. Rodríguez Rodríguez, Petros Malitas, Alessandra Fornaro, Nduka C. Okwose, Lazar Velicki, Lars Siegfried Maier, Maria Tafelmeier, Andrej Preveden, Duncan Edwards, José Luis Zamorano, Petar Seferović, Massimo Milli, Meritxell Ascanio, Anne Pauline Nelissen, Fatima Bano
article en
1 citations

Abstract

Heart failure (HF) affects over 64 million individuals worldwide and is a major cause of hospitalization and mortality, particularly among older adults. In Europe, HF imposes a significant and growing economic burden. This systematic review aimed to evaluate the economic impact of HF diagnosis, treatment and management across European healthcare systems. A systematic literature search was conducted using PubMed, Cochrane Library and Econlit databases including the terms 'heart failure' AND 'costs' OR 'cost of illness' OR 'cost analysis' OR 'economic burden' OR 'cost effectiveness' OR 'primary care' OR 'secondary care'. Studies published between January 2000 and January 2024 were included. A total of 49 studies were included: 17 on resource use, 11 on costs, 15 on resource use and costs, 1 on costs and cost-effectiveness, and 5 on resource use, costs and cost-effectiveness. Hospitalizations and medication use were the most frequently reported resource parameters. Annual HF-related costs varied widely across countries, ranging from €613 to €22,647 per patient. Hospitalizations represented the primary cost driver, accounting for 15% to 92% of total HF costs. Cost-reduction strategies included multidisciplinary care, telemonitoring and pharmacologic interventions. Several disease management programmes reduced hospital admissions and emergency visits. Cost-effectiveness analyses supported the use of certain HF therapies, with incremental cost-effectiveness ratios ranging from €1490 to €9406 per QALY gained. F imposes a substantial economic burden in Europe, largely driven by hospitalizations. Cost-effective interventions such as remote monitoring and integrated care programmes can reduce this burden. Broader adoption of these strategies may improve outcomes and optimize resource allocation across healthcare systems.

ESC Heart FailureVol. 12(6)
Serbian Academy of Sciences and Arts (RS), University of Kragujevac (RS), University of Ljubljana (SI), University of Novi Sad (RS), University of Cambridge (GB), Business School Lausanne (CH), Instituto de Salud Carlos III (ES), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), University Hospitals Coventry and Warwickshire NHS Trust (GB), University Medical Center Utrecht (NL), University Hospital Regensburg (DE), University of Belgrade (RS), Clinical Research Institute (US), Centro de Investigación Biomédica en Red de Salud Mental (ES), Victimology Society of Serbia (RS), Azienda Ospedaliero-Universitaria Careggi (IT), Institute for Cardiovascular Diseases of Vojvodina (RS), NIHR Newcastle Biomedical Research Centre (GB), Health Economics and Outcomes Research (United Kingdom) (GB), Primary Health Care (QA), Wellcome Centre for Mitochondrial Research (GB), Bioengineering Center (RU), Azienda Usl Toscana Centro (IT), Centro de Investigación Biomédica en Red de Cáncer (ES), Hospital Universitario Ramón y Cajal (ES), Barcelona School of Economics (ES), University of Florence (IT), University of Regensburg (DE), Universitat de Barcelona (ES), Coventry University (GB), University of Newcastle Australia (AU), Newcastle University (GB), Foundation for Research and Technology Hellas (GR)
UK Research and Innovation, National Institute for Health and Care Research, European Commission, HORIZON EUROPE Framework Programme, Staatssekretariat für Bildung, Forschung und Innovation, NIHR Newcastle Biomedical Research Centre
Openalex Percentile: Top 13%
Heart Failure Treatment and Management
1.39
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