Acute coronary syndrome (ACS), specifically myocardial infarction, accounted for approximately 41% of deaths due to coronary artery disease in 2013. A large number of Filipinos are affected by ACS; thus, it is important to determine its hospitalization cost. The study objectives were to (1) define the hospital care pathways for ACS; (2) determine the resources used; (3) estimate the hospitalization cost for uncomplicated ACS; and (4) determine the difference between the estimated hospitalization cost and the coverage provided by the Philippine Health Insurance Corporation (Philhealth).

A cost analysis study was done. Mixed qualitative and quantitative data collection tools consisted of consultations with local cardiologists, key informant interviews, and self-administered survey forms. Sensitivity analysis was performed through scenario analysis.

The ACS hospital care pathway was derived after consultative meetings with invasive and noninvasive cardiologists. Using this pathway, the resources used for ACS hospitalization were identified, and the total hospitalization costs were calculated. For medical treatment alone, the costs were approximately Philippine peso (₱) 67,000 to ₱90,000, whereas for medical treatment with percutaneous coronary intervention (PCI), the costs were approximately ₱265,000 to ₱425,500. In comparison, Philhealth's maximum coverage for ACS with PCI is ₱39,750.

There is variation in the ACS hospitalization cost, depending on the management strategy used and the type of hospital where a patient is confined. Medical plus reperfusion with PCI increases the cost four to five times when compared with medical treatment alone. Huge out-of-pocket expense is demonstrated because of the large discrepancy between the actual hospitalization costs to Philhealth's ACS coverage.