Assessing the burden of heart failure in China

Developing real world understanding of care pathways and resource utilisation

The challenge

Little was known about the real world healthcare practice for heart failure patients in China. Our client needed to understand treatment practice patterns and patient composition to better target their product development and to populate cost effectiveness models in heart failure. Data collection in China could be difficult, therefore real world patient data on treatment experiences needed collecting in a manner that would be generalisable to the target audience.

The solution

We designed a study including a chart review and phone interview to develop a real world understanding of patients and their treatment for heart failure in China. We worked closely with KOLs to ensure the relevancy and feasibility of the chart abstraction to achieve characterisation of heart failure and its real world treatment.

To ensure generalisability, 10 hospitals in 5 regions were recruited. Data were stratified by region and by New York Heart Association (NYHA) classification.

To capture potential missing data, each subject was contacted to determine if there were any additional healthcare services associated with heart failure not recorded in the patient’s chart. Each subject or a relative provided consent to use data from their medical records.

Key results

• Total hospitalisation costs were highest in NYHA class III patients, for both resource and medical utilisation.
• More cardiac surgeries were performed in NYHA class III compared to other NYHA classes
• The main cost drivers were diagnostic procedures and high-cost cardiac surgeries performed in a minority of patients. Over 70% of cardiac surgeries were performed during the index hospitalisation, accounting for over 70% of all costs in the index hospitalisation.
• Stent and CRT were the most commonly performed cardiac surgeries.
• The number of diagnostic procedures increased with subsequent hospitalisations and became the main cost driver at the fourth hospitalisation.
• One year mortality increased with each subsequent hospitalisation, from 6% after the first to 31% after the fourth.
• Regional differences in costs and resource consumption between treatments were identified.

In China, heart failure was a resource intensive condition with surgery and diagnostic procedure costs as key drivers. As such, it presented a large burden to the healthcare system in the 5 major regions in China, with some regional variations.

Value to the client

This research allowed our client to understand the general landscape of heart failure in China as well as develop estimates that could be later input into economic models.