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The Pharmaceutical Journal
Vol 269 No 7225 p736
23 November 2002

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Royal College of Physicians: "How hospitals manage heart attacks" report (more)
Heart Online: abstract (more)


Heart disease is the most costly condition in the UK

Coronary heart disease (CHD) cost over £7bn in 1999, making it the United Kingdom's most expensive medical condition, according to health economists.

Researchers from the Institute of Health Sciences in Oxford calculated that the cost of CHD to the National Health Service was £1.73bn, while informal care costs and/or revenue lost due to decreased productivity amounted to about £5.3bn. Just over half of NHS cost was attributed to hospital inpatient care (£917m) and about a third to drug treatment (£558m) (Heart 2002;88:597). This latest estimate for the total cost of CHD is some seven to 10 times higher than that calculated by previous studies. The researchers say this is because previous studies have not taken lost productivity and earnings into account when calculating the total financial burden of the disease.

CHD is followed by back pain as the next most expensive condition, which cost the UK about £6.8bn in 1999, and rheumatoid arthritis, costing £2bn. Alzheimer's disease and lower respiratory tract infections cost the NHS alone approximately £2bn and £1.8bn, respectively — more than back pain and CHD. However, there are no data on other costs, so the total burden of these conditions on the UK economy is not known.

Myocardial infarction audit Data from the first Myocardial Infarction Audit Project has revealed that hospitals in the UK are, on average, meeting Government targets for prescribing aspirin, beta-blockers and statins to patients who have had a heart attack. However, they fare less well in terms of the time it takes to initiate thrombolytic treatment when a patient first arrives at the hospital. The Government says that three-quarters of those needing thrombolysis should receive it within 30 minutes of arrival, however only 28 per cent of hospitals met this target in the first half of this year.

The audit was published this week by the Royal College of Physicians clinical effectiveness and evaluation unit, and can be viewed here.

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