Heart failure: assessment of the global economic burden

BACKGROUND AND AIMS: Heart failure (HF) is a major public health issue, imposing substantial costs on healthcare systems and societies. This study aimed to provide a contemporary overview of its global economic impact. METHODS: A systematic search of four databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting direct cost (DC) and/or indirect cost (IC) associated with HF were included. DC and IC were expressed as a percentage of current healthcare expenditure (CHE) and gross domestic product (GDP), which were obtained for 2021 from the World Health Organization Global Health Expenditure Database. Countries were categorized by their Human Development Index (HDI), and weighted group means were calculated to estimate costs based on their 2021 expenditure. RESULTS: Thirty-two studies met the inclusion criteria. In 2021, the estimated economic burden of HF was 284. 17 billion across 179 countries. This included 136. 86 billion (48. 16%) in DC and 147. 31 (51. 84%) billion in IC. Very high HDI countries account for most absolute HF spending, but HF comprises a smaller share of CHE and GDP (1. 07% DC, 0. 09% IC) compared with low HDI countries (8. 85% DC, 0. 29% IC). CONCLUSIONS: The global economic burden of HF is substantial, increasing, and varies across countries. Although very high and high HDI countries carry most of the absolute costs, low HDI countries bear a disproportionate burden relative to their total healthcare expenditure or GDP. Data scarcity in these settings further impedes accurate burden estimates. To address this growing challenge, proactive and cost-effective measures tailored to each country's healthcare system are crucial in optimizing HF care worldwide.