Costs related to atherosclerotic cardiovascular disease in Brazil: analysis from the perspective of the society

Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD)—including ischemic heart disease (IHD), ischemic stroke (IS), and peripheral arterial disease (PAD)—is a leading cause of death and disability worldwide, creating a significant socioeconomic burden. In Brazil, ASCVD accounts for most cardiovascular-related hospitalizations and deaths; comprehensive national estimates of societal costs for IHD, IS, and PAD are still limited. This study aims to estimate the direct and indirect societal costs of IHD, IS, and PAD in Brazil from both public and private healthcare perspectives, and to project their economic burden for the 2025–2029 period. Methods: Data were extracted from official national databases, including DATASUS (public sector), TISS (private sector), SIM (mortality), and InfoLogo (social security). Direct medical costs were derived from hospitalizations recorded between 2008 and 2023. Indirect costs included productivity losses due to absenteeism and premature mortality among individuals aged 14–64 years. Future costs were projected using the Exponential Smoothing with Error, Trend, and Seasonality (ETS) model. Results: ASCVD is projected to cause over 600,000 hospitalizations annually in Brazil, generating direct medical costs exceeding BRL 5.9 billion in 2029. Indirect costs related to premature mortality and absenteeism will reach approximately BRL 4.5 billion annually. The total projected 5-year societal burden (2025–2029) amounts to BRL 59.4 billion, with IHD representing the largest share of both direct and indirect costs. Conclusions: ASCVD imposes a substantial and growing economic burden on Brazilian society, driven primarily by direct healthcare expenditures and productivity losses from premature deaths. These findings highlight the need for strengthened prevention, early detection, and risk-factor management strategies to mitigate the clinical and economic impact of atherosclerotic disease in Brazil.