Does Prevention of Cardiovascular Diseases Lead to Decreased Cost of Illness? Twenty Years of Experience from Finland

Background.During the past 20 years the age-standardized cardiovascular disease mortality rate has declined in Finland by 50%. The aim of this study was to examine the social cost consequences of this decline. Methods.The prevalence-based cost-of-illness analysis was applied to estimate both direct and indirect costs of cardiovascular disease in 5-year intervals from 1972 to 1992 (in 1992 prices). Summary data from the national registers covered all persons with cardiovascular disease who were treated, received sickness insurance benefits, or died from the disease. Results.Direct health care costs increased, but the decline in indirect costs overcompensated that increase. The total cost among all persons age 35 and over, including the retired, was $2.7 billion in 1972 and $2.6 billion in 1992, which is a 4% decrease. In the age group of 35–64 years the total costs fell from $2.5 billion to $1.9 billion (25%). In terms of cost per capita the decline was 26 and 40% in the respective age groups. Conclusions.The costs of cardiovascular disease decreased since 1972. However, total costs declined clearly less than the cardiovascular disease mortality rate. This implies that considerable savings in total costs, especially in direct health care costs, may not be expected as a result of even very successful prevention programs.