7 in 10 heart failure patients in India lack financial cover; treatment costs push families to brink | India News

New Delhi: For thousands of Indians living with heart failure, the biggest strain is not just the disease, but the cost of living with it. A nationwide study found that seven out of 10 patients have no financial protection, forcing families to pay almost entirely out of their own pockets.Published in Journal Global HeartThe study, led by Dr. Panniammakal Ziman of SCTIMST, Thiruvananthapuram, analyzed 1,859 patients from 21 tertiary hospitals in India between September 2019 and December 2022.It shows that more than 90% of medical costs are borne directly by patients, revealing a deep gap in financial protection for chronic illnesses.The numbers reflect a harsh reality. An average patient spends more than ₹1 lakh a year on treatment. At the same time, incomes are falling – nearly one in three patients and a third of families report a loss of income after diagnosis.Doctors say incomes are often reduced as patients stop working and families turn to caregiving. About 38% face catastrophic expenses and nearly one in six borrow or sell assets, cutting many basic costs. The burden is greatest on rural, low-income and uninsured patients.Insurance provides some relief – but not enough. Schemes like Ayushman Bharat provide coverage for hospitalization, but gaps remain. Most schemes do not fully cover outpatient care, medication and long-term follow-up – which form a major part of the treatment of chronic conditions such as heart failure. As a result, patients end up spending a lot of money out of their own pockets.“Heart failure care in India shows a clear gap between acute treatment and long-term management, driven by affordability, accessibility and availability,” said Dr Mohit Gupta, cardiologist, GTB Hospital. “Costs often force patients to cut medications, delay follow-up, or skip tests. The biggest burden is repeated hospitalizations, not medications. We often treat patients according to affordability. Insurance largely covers hospitalization, but heart failure is a chronic outpatient disease, and medication and follow-up gaps in patient care. Increasing access to affordable medicines and structured follow-up can improve outcomes and reduce costs.”Dr Ambuj Roy, Professor of Cardiology, AIIMS said that insurance schemes still favor one-time approach over sustained care, when heart disease requires long-term treatment. Although new drugs have improved survival and quality of life, most patients pay out of pocket, making heart failure treatment a significant financial burden.”Experts warn that financial stress leads to delays in care and skipping medications, worsening outcomes. Despite improved access, financial protection lags, complicating outpatient care and drug coverage.