Skyrocketing Costs of CVD Will Be Amplified by Informal Caregiving: AHA

Costs of cardiovascular disease related to medical expenditures and lost productivity are expected to soar over the next two decades, but there are additional “informal” costs that will add significantly to the financial burden attributable to CVD by the year 2035.

These are the conclusions of a new statement released by the American Heart Association (AHA) today with the aim of influencing policymakers tasked with reducing the economic impact of CVD on healthcare and society.

“Informal caregivers are indispensable assets to our healthcare system and often play a significant role in the recovery and well-being of heart disease and stroke survivors,” AHA CEO Nancy Brown said in a press statement. “By 2035, the number of Americans living with heart disease and stroke will rise to $131.2 million—45 percent of the total US population. Understanding the escalating burden this will place on the family members and friends who care for these individuals is essential if we are to address this looming crisis.”

A report commissioned last year by the AHA estimated that direct medical costs and costs related to lost productivity attributable to cardiac diseases and stroke would grow from $555 billion in 2015 to $1.1 trillion by 2035. That figure, however, does not take into account the cost of informal caregiving, typically provided at home, by family members or friends.

In the paper published today in Circulation, Sandra Dunbar, RN, PhD (Emory University, Atlanta, GA), and colleagues estimated hours of informal caregiving for CVD using data from the 2014 Health and Retirement Survey. Costs were calculated separately for coronary heart disease, hypertension, heart failure, stroke, and other forms of cardiac disease then projected from 2015 to 2035, assuming that CVD prevalence and caregiving hours would remain static.

Based on their calculations, estimated informal caregiving costs in the United States reached $61 billion in 2015, with more than half of those costs related to caring for stroke survivors. By 2035, Dunbar and colleagues estimate that informal costs will more than double, reaching 126 billion. These added dollars represent an additional 11% on top of the $1.1 trillion already estimated for more formal costs in the next two decades.

To meet the growing needs of caring for cardiovascular disease patients, the authors propose four strategic steps:

• Creation and deployment of a national caregiving strategy
• Expansion of access to palliative care
• Caregiver participation/consideration within performance and payment reforms
• Investment in caregiving research

Caregivers have become a “critical issue” for public policy, they conclude.

“CVD is already our nation’s costliest disease, and the projected dramatic rise in CVD prevalence and costs between now and 2035 portends increased strain on the capacity of the health system and demands imposed on informal caregivers at the same time that the caregiver pool is shrinking,” Dunbar et al write. “These circumstances place CVD caregivers at risk for their own health deterioration and burnout from the prolonged distress, physical demands, and costs of caregiving, and as demonstrated in this analysis, our nation will bear the costs.”