European Heart Journal Advance Access originally published online on February 22, 2006
European Heart Journal 2006 27(13):1610-1619; doi:10.1093/eurheartj/ehi733
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Economic burden of cardiovascular diseases in the enlarged European Union
1 Department of Public Health, Health Economics Research Centre, Oxford University, Old Road Campus, Oxford OX3 7LF, UK
2 Department of Public Health, British Heart Foundation Health Promotion Research Group, Oxford University, Old Road Campus, Oxford OX3 7LF, UK
Received 6 May 2005; revised 20 December 2005; accepted 22 December 2005; online publish-ahead-of-print 22 February 2006.
* Corresponding author. Tel: +44 1865 226690; fax: +44 1865 226842.E-mail address: jose.leal{at}dphpc.ox.ac.uk
See page 1521 for the editorial comment on this article (doi:10.1093/eurheartj/ehl075)
Aims Cardiovascular disease (CVD), together with its main components, coronary heart disease (CHD), and cerebrovascular diseases, is the main source of morbidity and mortality in the European Union (EU), but to date, there has not been any systematic cost-of-illness study to assess the economic impact of CVD in the EU.
Methods and results CVD-related expenditure was estimated using aggregate data on morbidity, mortality, and healthcare resource use. Healthcare costs were estimated from expenditure on primary, outpatient, emergency, and inpatient care, as well as medications. Costs of unpaid care and lost earnings due to morbidity and premature death were included in the study. CVD was estimated to cost the EU 
169 billion annually, with healthcare accounting for 62% of costs. Productivity losses and informal care represented 21% and 17% of costs, respectively. CHD represented 27% and cerebrovascular diseases 20% of overall CVD costs.
Conclusion CVD is a leading public health problem. Our study is the first to assess the economic burden of CVD across the EU, and our results should help policy makers evaluate policy impact and prioritize research expenditures. However, because of data unavailability, our study has important limitations, which highlight the need for more accurate and comparable CVD-specific information.
Key Words: Cardiovascular disease • Coronary heart disease • Cerebrovascular diseases • Cost-of-illness study • Europe
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