Heart failure: assessment of the global economic burden

A systematic search of four databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting direct cost (DC) and/or indirect cost (IC) associated with HF were included. DC and IC were expressed as a percentage of current healthcare expenditure (CHE) and gross domestic product (GDP), which were obtained for 2021 from the World Health Organization Global Health Expenditure Database. Countries were categorized by their Human Development Index (HDI), and weighted group means were calculated to estimate costs based on their 2021 expenditure.

Thirty-two studies met the inclusion criteria. In 2021, the estimated economic burden of HF was $284.17 billion across 179 countries. This included $136.86 billion (48.16%) in DC and $147.31 (51.84%) billion in IC. Very high HDI countries account for most absolute HF spending, but HF comprises a smaller share of CHE and GDP (1.07% DC, 0.09% IC) compared with low HDI countries (8.85% DC, 0.29% IC).