Heart Disease and Stroke in Canada 1997

5. Economic Impact of Cardiovascular Disease

Cardiovascular diseases have a significant economic impact in Canada as measured by direct costs³⁵. Direct costs refer to the value of resources actually expended that could have been allocated elsewhere in the absence of disease.

Cardiovascular diseases were the most expensive disease category in 1995 accounting for $7.3 billion or 17% of the total direct costs of illness. Figure 17 illustrates the total direct costs for each diagnostic category. The sources of the direct costs of cardiovascular disease are illustrated in Figure 18. Direct costs are comprised of hospital expenditures, medical care, drugs, and research. Hospital care was the most expensive direct cost component ($4.8 billion or 66% of the total direct costs) for cardiovascular diseases. The costs of medical services provided by physicians for the treatment of cardiovascular disease amounted to $867 million. Prescription drugs distributed to the Canadian consumer through drug stores and hospitals for the treatment of cardiovascular diseases cost an estimated $1.6 billion. Approximately $59 million (0.8%) has been allocated to research.

Other costs play a significant role in the economic burden of illness in Canada. Indirect costs include the value of lost productivity due to illness or disability, and the loss of future earnings due to premature death (see Section 2.7 , Potential Years of Life Lost). Indirect mortality costs are calculated utilizing the human capital approach which estimates the current dollar value of lost future productivity due to premature death ³⁶. Indirect cost estimates have been calculated for all disease categories (figures 19 and 20). Musculoskeletal disorders account for the greatest indirect costs at an estimated $15.3 billion annually (figure 19). Cardiovascular disease is second at approximately $12.3 billion annually or 14.5% of total indirect costs of all disease categories. This is greater than injuries, cancer and respiratory diseases. By far the greatest proportion of indirect costs for cardiovascular disease is mortality, which is 60% of the total at $7.4 billion annually (figure 20). Long-term disability has a significant proportion at 36.4% or $4.5 billion annually. Short-term disability is a minor component at 3.4% or $425 million annually³⁷.

When combined, the direct costs plus the indirect costs of cardiovascular disease consume a significant portion of the health care dollar. These economic statistics do not include the personal and emotional components of the burden of cardiovascular disease. Both the economic and personal burdens of cardiovascular disease demonstrate the great need to reduce its incidence, improve the treatment of its manifestations, and reduce its long-term disability and mortality. As well, the economic analysis dramatically demonstrates the need to determine accurate incidence and prevalence rates of cardiovascular disease in Canada in order to plan the appropriate allocation of scarce health care funds.

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