Dhruv Kazi Profile picture
Jun 4 10 tweets 4 min read Read on X
Two @American_Heart Presidential Advisories released today project the future burden of #heartdisease and #stroke in the US
– and the numbers are truly astounding
@CircAHA

What will cardiovascular disease look like in 2050? And how much will it cost?

🧵 tinyurl.com/AHACVCosts
Image
We project steep increases diabetes, obesity, and hypertension, and, as a result, large increases in cardiovascular disease

By 2050,
Prevalent CVD = 45 million (60%⬆️)
Diabetes = 80 million (100% ⬆️⬆️)
Obesity = 180 million (70% ⬆️)
Hypertension = 180 million (44% ⬆️)

2/ Image
Also by 2050:

a 100% ⬆️⬆️ in the number of US adults living with stroke (19 million), and
a 66% ⬆️in people living with heart failure (11 million)
3/ Image
All of this comes at a $$$.

By 2050, projected costs of treating CVD and stroke in US adult

Total costs =$1.85 Trillion (195% ⬆️⬆️)
including
Health care costs = $1.49 Trillion (279% ⬆️⬆️⬆️)

Cost of CVD will represent 4.6% of the US GDP
4/ Image
Tons of details in the papers, but some striking numbers:

1049% increase in health care costs of stroke ($351 billion) (!)
274% increase in the HC cost of HF ($121 billion)

5/
Costs show big increases in older adults
(aging population)

but also rise in younger age groups
(increasing burden of risk factors, diversifying US popn).

And a worrisome finding: 2/3 of the cost will be borne by Medicare
6/
Image
Image
Increases in all race/ethnicity groups but particularly large (almost *500%*) relative increases in Asian American and Hispanic American populations due to increasing population size

7/ Image
So, what can we do about this?

Each of us needs to know & work on our own CV risk

As a society:
Invest in cost-effective prevention strategies. esp for communities at highest risk
Advocate for affordable universal healthcare
Invest in research (basic, clinical, implementn)
Predictions are always challenging (and we are transparent about our assumptions and limitations in the paper) - but they offer a roadmap

In the word of editorialist
Elizabeth Magnuson

Soaring Costs are a Call to Arms
ahajournals.org/doi/epdf/10.11…
Papers here:



@american_heart news release here


Shout out to @kejoynt @MitchElkind and all co-authors and staff who made these papers possibletinyurl.com/AHACVDPrev
tinyurl.com/AHACVCosts
tinyurl.com/AHAForecastNews

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More from @kardiologykazi

Mar 17, 2021
Building on yesterday’s tweetorial on #COVID19 vaccine economics, here’s part 2:

- How will costs change over time?
- “Never mind the costs, focus on health equity”
- What about the J&J vaccine?
- Are vaccination efforts sustainable?

THREAD
@Bob_Wachter @KBibbinsDomingo @rwyeh
ICYMI

Top-line results from yesterday’s tweetorial:

- The US govt has paid $40-105 per person for the vaccine

- It may cost an additional $70-90 per person into people’s arms (vs. $45 that Medicare is currently offering to pay).

2/
How will the COVID-19 vaccination change over time?

Initially delivery costs per person ⬇️as we build mega-sites (lower per-person $ than small clinics), but then costs ⬆️as we target hard-to-reach folks.

In business-speak, "cost of customer acquisition" may ⬆️ over time.

3/
Read 17 tweets
Mar 16, 2021
The US program for #COVID19 vaccination is progressing well – but how much does COVID-19 #vaccination cost per person?

I recently discussed this @HarvardMed Grand Rounds & figured I'd share some thoughts with #medtwitter.
@ashishkjha @Bob_Wachter @KBibbinsDomingo
THREAD
1/
First, a quick poll.

How much do you think #COVID19 vaccination costs PER PERSON in the US?

2/
Ok, let's get started.

Here’s what we’ll discuss in this thread. Note that I make a distinction between the cost of the vaccine ($ paid to manufacturer) and the cost of vaccination (total $ of putting two doses of the vaccine in people’s arms).

3/
Read 20 tweets
May 4, 2020
How much should we be willing to pay for a course of #remdesivir?

A new report by @icer_review suggests $4,460 per hospitalized patient with #COVID19.

As always, the devil is in the details.

THREAD 1/
@EricTopol @Bob_Wachter @KBibbinsDomingo
@icer_review's approach is transparent and parsimonious (which is good).

Assumes:
- 66% admitted to med-surg floor ($13K, 4% mort)
- 8% to ICU, no vent ($34K, 10% mort)
- 28% to ICU on vent ($61K, 31% mort).

Seem reasonable. 2/
It assumes remdesivir shortens recovery time.

It also assumes remdesivir reduces mortality by *31%* based on the NIH announcement re ACCT: "a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059)."

That's a high bar.

3/
Read 10 tweets

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