Costs Related to Atherosclerotic Cardiovascular Disease in Brazil: Analysis From the Perspective of the Society

Background Cardiovascular diseases are the leading cause of death globally. High-risk individuals face costs from premature death and productivity loss due to sick leave and retirement. In Brazil, the economic burden of hypertension, heart failure, myocardial infarction, and atrial fibrillation was estimated at 56 million Brazilian reais (BRL) in 2015, including both direct and indirect costs. Understanding the burden of a disease is essential for proposing effective public policies. Using DATASUS data, this study estimated the costs of atherosclerotic cardiovascular disease (ASCVD) in Brazil from a societal perspective. Methods This analysis used data from 2008 to 2023, focusing on three types of ASCVD: ischemic heart disease (IHD), ischemic stroke (IS), and peripheral arterial disease (PAD). The DATASUS hospital database was used to quantify direct costs in the public system and collect patient demographic details. Estimates for direct costs on the private system were based on the TISS database, while social security benefits were sourced from the Brazilian Ministry of Social Security. Results ASCVD lead to over 600,000 hospitalizations annually in Brazil, predominantly in the public system (82%). Coronary Artery Disease (CHD) imposes the highest costs, while PAD incurs the lowest. Indirect costs related to death represent nearly BRL 4 billion annually, similar magnitude to all direct medical costs. The indirect costs from absenteeism are approximately BRL 181 million per year, significantly lower than the magnitude of direct medical and death-related indirect costs. There is a trend that shows that absenteeism-related costs are decreasing, possibly due to the increase in mortality rates in patients with IHD. In Brazil, social security benefits for cardiovascular diseases total about BRL 100 million annually, with IHD being the most significant. The annual economic burden of these diseases is around BRL 10 billion, expected to reach BRL 60 billion in the next five years. Conclusions In conclusion, ASCVD present a significant economic burden in Brazil, primarily through direct medical costs in the public system. Indirect costs from premature deaths and productivity losses are also substantial. The high mortality rate among economically active individuals worsens these impacts. To reduce costs, focusing on targeted prevention, early diagnosis, and effective treatment is essential.