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Economic burden of heart failure in Europe: A systematic review of costs and cost-effectiveness

Lookup NU author(s): Dr Sarah CharmanORCiD, Dr Renae StefanettiORCiD, Dr David SinclairORCiD, Dr Guy MacGowanORCiD, Professor Djordje JakovljevicORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2025 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.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.


Publication metadata

Author(s): Darba J, Ascanio M, Rodriguez A, Charman SJ, Okwose NC, Stefanetti RJ, Groenewegen A, Del Franco A, Tafelmeier M, Preveden A, Fuller AS, Bano F, Sinclair DR, Edwards D, Nelissen AP, Malitas PN, Zisaki A, Bosnic Z, Vracar P, Fornaro A, Barlocco F, Fotiadis D, Banerjee P, MacGowan GA, Fernandez O, Zamorano JL, Jimenez-Blanco Bravo M, Maier LS, Olivotto I, Milli M, Rutten FH, Mant J, Velicki L, Seferovic PM, Filipovic N, Jakovljevic DG, Sasso L, Milazzo A, Taborchi G, Fatucchi S, Milovancev A, Williams K, Jecheche P, Flis B, Boucharas D, Manousos D, Tsiknakis M, Kassiotis T, Sustersic T, Milicevic B, Gacic M, Kaplarevic M, Hobbs FDR, Kaagman O

Publication type: Review

Publication status: Published

Journal: ESC Heart Failure

Year: 2025

Volume: 12

Issue: 6

Pages: 4055-4068

Print publication date: 01/12/2025

Online publication date: 26/11/2025

Acceptance date: 16/10/2025

ISSN (print): 2055-5822

ISSN (electronic): 2055-5822

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1002/ehf2.70017

DOI: 10.1002/ehf2.70017

PubMed id: 41296502


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