805,000 heart attacks and 795,000 strokes occur annually.1
The top 5% of plan participants with cardiovascular disease spend over 67% of healthcare expenditure on inpatient care.4
Every 40 seconds in the United States, a patient has an MI. Another patient has a stroke.1
Cardiovascular disease describes problems that affect the heart and its blood vessels, including heart attack, stroke, heart failure, and arrhythmia. Some of these conditions are related to atherosclerosis, a process that occurs when plaque builds up inside the arteries. Plaque is made up of cholesterol, fats, and other substances. As plaque builds up, it can partially or totally block the flow of blood through the arteries. This may result in a heart attack or stroke.5,6
Not enough physical activity
High cholesterol levels
High blood pressure
Diabetes, metabolic syndrome
The prevalence of cardiovascular disease is expected to increase from 100 million (2015) to 130 million (2035), making this an urgent issue.3
Cardiovascular disease is one of the most expensive medical conditions for the medical system and for employers: the costs related to treating cardiovascular disease is expected to more than double from 2015 to 2035, increasing the costs from $555 billion to $1.1 trillion.3
The average cost of cardiovascular disease is $329 per member per year.9
The top 5% of plan participants with cardiovascular disease spend over 67% of healthcare expenditures on inpatient care vs only 5% on prescriptions.4
Mean 1-year direct medical costs for the first cardiovascular event can be between $41,146 and $79,253.10
43% of those with a prior CV event had at least 1 new CV event within 2 years.1 The minimum average cost* of a subsequent event is over $63,000.2
*Costs included pharmacy costs and medical costs (inpatient services, emergency department, office visits, and outpatient services). Costs were calculated as the sum of the patient out-of-pocket costs and the amount paid by the health plan. All costs were inflated to 2013 dollars based on the Consumer Price Index.
The total cost for patients who require a secondary hospitalization can be up to 4.5 times higher than those who are not hospitalized.11
Employers also face high indirect costs. Employees with cardiovascular disease cost their employers about $1,119 more in workplace absenteeism and short-term disability costs in the first month alone. Employees with cardiovascular disease also lose 56 hours more in productivity in the first month following a cardiovascular event. While costs are highest in the first month following a cardiovascular event, employers may pay more through the first year for workplace absenteeism and up to 3 years for short-term disability.12
Employers play an integral role in helping individuals improve cardiovascular health.
At the organizational level, employers can identify opportunities across the continuum of care to reduce cardiovascular disease costs, improve care, and enhance the employee experience.13
Optimize the workplace environment: Build a culture that promotes health, performance, and productivity.
Optimize cardiovascular disease care delivery: Work with your health plan to monitor and manage acute cardiovascular disease episodes and minimize inefficient cardiovascular disease care.
Engage your health plan: Review current and prospective health plans to ensure the plans include appropriate benefits to cover your employees’ heart health.
Engage Employees at the Individual Level
Offer programs that target high-risk cardiovascular behaviors for all employees. Such programs may help avoid costly cardiovascular events.
Promote healthy behaviors: Measure and reward healthy eating, physical activity, nonsmoking, and moderate or no alcohol use.
Reduce unnecessary procedures: Encourage patient understanding of the full range of care options, including the benefits and harms of each, and encourage employees to express their values and preferences in dialogue with their physicians.
Optimize chronic care: Encourage education and engagement skills to improve health behaviors, promote self-monitoring for the disease, and promote adherence to prescribed medications.
Population Health Resources
Visit Amgen’s Population Health website for useful resources and examples of improving employee cardiovascular health.
Cardiovascular Costs and
Risk Management for Employers
References: 1. Benjamin EJ, Muntner P, Alonso A, et al. Heart Disease and Stroke Statistics—2019 Update. Circulation. 2019;139:e56-e528. 2. Punekar RS, Fox KM, Richhariya A, et al. Burden of First and Recurrent Cardiovascular Events Among Patients With Hyperlipidemia. Clin Cardiol. 2015;38:483-491. 3. American Heart Association. Projections of Cardiovascular Disease Prevalence and Costs (Technical Report): 2015–2035. November 2016. healthmetrics.heart.org/wp-content/ uploads/2017/10/Projections-of-Cardiovascular-Disease.pdf. Accessed May 13, 2020. 4. Cohen SB. MEPS Brief #455. meps.ahrq.gov/data_files/publications/st455/ stat455.pdf. Accessed May 13, 2020. 5. American Heart Association. About Heart Attacks. www.heart.org/en/health-topics/heart-attack/about-heart-attacks. Accessed May 13, 2020. 6. American Heart Association. Warning Signs of a Heart Attack. www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack. Accessed May 13, 2020. 7. Grundy SM, Stone NJ, Bailey AL, et al. Guideline on the Management of Blood Cholesterol: Executive Summary. J Am Coll Cardiol. 2019;73(24):3168-3209. 8. American Heart Association. Coronary Artery Disease - Coronary Heart Disease. www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease. Accessed May 13, 2020. 9. Goetzel RZ, Henke RM, Head MA, et al. Workplace Programs, Policies, And Environmental Supports To Prevent Cardiovascular Disease. Health Aff. 2017;36(2):229-236. 10. Bonafede MM, Johnson BH, Richharlya A, Gandra SR. Medical costs associated with cardiovascular events among high-risk patients with hyperlipidemia. Clinicoecon Outcome Res. 2015;7:337-345. 11. Nichols GA, Bell TJ, Pedula KL, O'Keeffe-Rosetti M. Medical care costs among patients with established cardiovascular disease. Am J Manag Care. 2010;16(3):e86-e93. 12. Song X, Quek RGW, Gandra ST, Cappell KA, Fowler R, Cong Z. Productivity loss and indirect costs associated with cardiovascular events and related clinical procedures. BMC Health Services Res. 2015;15(245):1-14. 13. Parkinson MD. Employer Health and Productivity Roadmap™ Strategy. J Occup Environ Med. 2013;55(12 suppl):S46-S51.