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Economic Burden of Heart Failure Care
Panelists discuss how heart failure creates a massive economic burden of approximately $30 billion annually (expected to reach $70 billion to $80 billion by 2030), driven by hospitalizations, readmissions, expensive multidrug regimens costing over $20,000 to $30,000 per patient, and high-cost interventions like ablations and advanced therapies.
EP: 1.Economic Burden of Heart Failure Care
EP: 2.Heart Failure Prevalence and Screening
EP: 3.Quality Metrics in Heart Failure
EP: 4.Heart Failure Stages and Impact of Delayed Diagnosis
EP: 5.Collaboration in Heart Failure Treatment
EP: 6.Guideline-Directed Medical Therapies in Heart Failure
EP: 7.β-Blockers for Treatment of Heart Failure
EP: 8.Role of Diuretics in Heart Failure Management
EP: 9.Treatment of Heart Failure With ARNI Therapy
EP: 10.SGLT2 Inhibitors for Treatment of Heart Failure
EP: 11.GLP-1 for Treatment of Heart Failure
EP: 12.Role of MRAs in Heart Failure Treatment
EP: 13.Steroidal vs Nonsteroidal MRAs in Heart Failure
EP: 14.Implementing MRAs for Heart Failure Treatment in the Clinic
EP: 15.Future Treatment Approaches in Heart Failure
The economic impact of heart failure extends beyond direct medical costs to encompass a complex landscape of expenditures that strain health care systems. Direct costs primarily stem from acute care episodes, hospitalizations, and readmissions, which account for approximately half of the $30 billion annual burden. Pharmacotherapy costs have increased substantially, with comprehensive 5-drug regimens potentially exceeding $20,000 to $30,000 annually per patient, representing a significant portion of total treatment expenses.
Less frequent but high-cost interventions are becoming increasingly prevalent as the population ages and survival improves with better treatments. These include atrial fibrillation ablations, cardiac resynchronization therapy, advanced device therapies, and treatments for conditions like amyloid cardiomyopathy. While individually expensive, these interventions are occurring more frequently and contributing proportionally more to the overall economic burden of heart failure management.
The financial implications extend to value-based care models where organizations assume total cost-of-care responsibility. This creates strong incentives to improve outcomes while controlling expenses, leading to innovative approaches in population health management. The Medicare Shared Savings Program and Accountable Care Organization REACH programs include specific cardiology quality measures with financial ramifications, including preventable heart failure admissions, postdischarge follow-up, β-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor‐neprilysin inhibitor utilization, and left ventricular function assessment, directly linking clinical performance to economic outcomes.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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