Seven of 10 heart failure patients in India lack fund shield, sell livelihood to survive, says new study

One out of three patients and households reported a decline in annual income following a heart failure diagnosis.

About 18 per cent of patients had difficulty continuing medication
In a small village near Kochi, 52-year-old Rajan, a farmer, sits quietly with a pile of hospital bills spread across his table.

Only weeks earlier, he was admitted to the hospital following persistent chest pain and breathlessness, symptoms that were eventually diagnosed as heart failure.

While the medical emergency was frightening, the financial costs were equally daunting.

To pay the mounting hospital charges, amounting to nearly Rs 1.2 lakh, Rajan was forced to sell his cow and calf, a vital source of income for his family.

His experience suggests how a serious illness can push families toward financial instability.

Now, a multicentre study, conducted by researchers at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala has highlighted the economic impact of heart failure treatment in India.

Findings of the study, which were published recently in the Global Heart journal, indicate that seven out of 10 heart failure patients in India lack financial health protection.

“Out-of-pocket expenditure, accounting for over 90 per cent of total health spending, contributes significantly to economic distress in heart failure patients,” said Dr Jeemon Panniyammakal, the first author of the study.

“Heart failure isn’t just a heart killer, it is a household impoverisher,” he added.

The absence of insurance increased spending by 28 to 38 per cent, he pointed out.

Only 30 per cent of patients had some form of insurance coverage.

That’s because insurance packages themselves are not too consistent or steep.

Some offer policies that pay a lump sum upon diagnosis of conditions like congestive heart failure.

Some cover hospitalisation expenses, cashless treatment at network hospitals and sometimes post-hospitalization rehabilitation.

But waiting periods are long before coverage applies and premiums are high because heart failure is a high-risk condition.

As per the study, one out of three individuals and households reported a decline in annual income following a heart failure diagnosis.

The study found that about 18 per cent of patients had difficulty adhering to their medications due to cost.

Heart failure is a chronic, progressive condition where the heart muscle is too weak or stiff to pump blood efficiently, failing to meet the body’s needs for oxygen.

While a chronic condition, it is managed through medications, lifestyle changes (e.g., reduced salt, smoking cessation) and sometimes devices like pacemakers.

How patients struggled with their bills
The study analysed data from 1,859 patients with heart failure treated at 21 tertiary care hospitals across the country between 2019 and 2022.

The average age of participants was 56 years.

Women accounted for about 30 per cent of the sample.

Nearly half of the patients came from rural areas, highlighting the widespread reach of the condition.

About 38 per cent of families experienced what researchers classify as “catastrophic health spending.” This term refers to situations where healthcare expenses exceed 40 per cent of a household’s capacity to pay.

In addition, 18 per cent of participants turned to distress financing such as borrowing money, selling property or liquidating assets, to pay medical bills.

For families already living with limited financial reserves, such measures can have long-term consequences.

According to the findings, the average cost of a single hospitalization for heart failure was approximately Rs 1.19 lakh.

To manage these costs, patients and their relatives often resorted to multiple financial coping strategies.

Around 68 per cent of respondents relied on their personal savings to cover expenses while 54 per cent received financial help from family members.

Another 15 per cent reported borrowing money from relatives or friends.

Despite these efforts, many households struggled to keep up with the growing expenses.

Heart failure (HF) affects an estimated 26 million people worldwide.

In India, it accounts for 1.8 million hospitalisations annually and places a considerable burden on the health system due to prolonged in-patient care and the need for long-term management, straining already limited healthcare resources.

India’s flagship public health insurance programme, Ayushman Bharat’s Pradhan Mantri Jan Arogya Yojana (PMJAY), provides annual coverage of up to ₹5 lakh per family for in-patient care, including certain heart failure-related procedures.

This provides a great relief to many families from the low-income groups.

However, the scheme does not cover outpatient consultations, follow-up appointments, or many essential medications, expenses that accumulate over time and significantly contribute to the overall cost of long-term care, according to study authors.

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune.

With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments.

She also takes a keen interest in covering women's issues .

Professional Background
Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature.

Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr.

Soumya Swaminathan, the former Chief Scientist at the WHO.

Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives.

Awards and Recognition
Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024).

A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021.

Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards.

She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.”
Recent Notable Articles (Late 2025)
1.

Cancer & Specialized Medical Care
"Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease.

Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose.

2.

Environmental Health (The "Breathless Pune" Series)
Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs.

"For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune.

3.

Lifestyle & Wellness News
At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents.

4.

Scientific Recognition & Infrastructure
For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics.

Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far.

Signature Beat: Health, Science & Women in Leadership
Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials.

She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields.

Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions.

...

Read More