CARDIOVASCULAR MEDICINE The economic burden of coronary heart disease in the UK

Objective: To estimate the economic burden of coronary heart disease in the UK using both direct and indirect costs. Design and setting: A prevalence based approach was used to assess coronary heart disease related costs from the societal perspective. Patients: All UK residents in 1999 with coronary heart disease (ICD 9 codes 410–414 and ICD10 codes I20–I25). Main outcome measures: Direct health care costs were estimated from spending on prevention, acci-dent and emergency care, hospital care, rehabilitation, and drug treatment. Direct non-health service costs were estimated from data on informal care. “Friction period ” adjusted productivity costs were estimated using the human capital approach from lost earnings attributable to coronary heart disease related mortality and morbidity. The friction period is the period of employees ’ absence from work before the employer replaces them with other workers. Failure to adjust for this factor would overstate production loss. Results: Coronary heart disease cost £1.73 billion to the UK health care system in 1999: £2.42 bil-lion in informal care and £2.91 billion in friction period adjusted productivity loss; 24.1 % of produc