Policy and Politics The Economic Burden of Chronic Cardiovascular Disease for Major Insurers

Accounting models provide less pre-cise estimates of disease burden than do econometric models. The authors seek to improve these estimates for cardiovascular disease using a nation-ally representative survey and eco-nometric modeling to isolate the proportion of medical expenditures attributable to four chronic cardiovas-cular diseases: stroke, hypertension, congestive heart failure, and other heart diseases. Approximately 17% of all medical expenditures, or $149 billion annually, and nearly 30 % of Medicare expenditures are attribut-able to these diseases. Of the four dis-eases, hypertension accounts for the largest share of prescription expendi-tures across payers and the largest share of all Medicaid expenditures. The large number of people with car-diovascular disease who are eligible for both Medicare and Medicaid could lead to large shifts in the burden to these payers as prescription drug cov-erage is included in Medicare. A soci-etal perspective is important when describing the economic burden of cardiovascular disease