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$115m bill

Torika Tokalau
Friday, June 06, 2014

ACUTE rheumatic fever (ARF) and rheumatic heart disease (RHD) has cost the Fiji health system an estimated $115,804,177 in the past five years, with about 60 Fijians dying each year as a result of RHD.

These alarming statistics were part of findings presented at the World Congress of Cardiology in Melbourne last month.

The study — conducted from 2008 to 2012 — was carried out by medical experts in Fiji and around the world, including Dr Joseph Kado, the head pediatrician and consultant at the CWM Hospital.

"The total direct costs and indirect costs of ARF and RHD in the study was estimated using prevalence and incidence estimates derived from the disease control program register, summaries of hospital inpatient and outpatient cases and bottom-up costing of units with and without surgery and complications," Dr Kado said.

He said the total cost included accommodation and food for visiting international surgical teams paid for by the Ministry of Health and the amount lost to patients for ongoing treatment.

He said the price of a valve used for a valve replacement surgery stood out as the most expensive aspect in the treatment of RHD. The valve costs $5000 to $10,000 per unit.

The study — based on the response of 2200 patients — revealed that the total direct costs of ARF and RHD were $3,985,329.99, which equates to an average $364.380 per patient annually.

Surgical costs constituted 17 per cent of total direct costs, with the remainder of direct costs attributable to inpatient and outpatient care. The indirect costs of these diseases however, the report states, dwarfs the direct costs.

The indirect costs of ARF and RHD total $111,818,847.37 over the study period, which equates to an average of $10,224.95 per patient annually.

The study reveals that of these indirect costs, 81.5 per cent are because of premature mortality of patients with RHD, with the remaining 18.5 per cent because of work absenteeism and health care utilisation.

"The full economic costs of ARF and RHD are relatively large in Fiji, which is also likely the situation in other RHD endemic countries," the study concluded.

"These data add further weight to the need for implementation of effective prevention and treatment strategies for RHD."








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