What are the cost-savings and health benefits of improving detection and management for six high cardiovascular risk conditions in England? An economic evaluation

To estimate the cost savings and health benefits of improving detection of individuals at high risk of cardiovascular disease (CVD) in England, to determine to which patient subgroups these benefits arise, and to compare different strategies for subsequent management. An economic analysis using the...

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Published in:	BMJ open Vol. 10; no. 9; p. e037486
Main Authors:	Thomas, Chloe, Brennan, Alan, Goka, Edward, Squires, Hazel Y, Brenner, Gilly, Bagguley, David, Buckley Woods, Helen, Gillett, Michael, Leaviss, Joanna, Clowes, Mark, Heathcote, Laura, Cooper, Katy, Breeze, Penny
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group LTD 10-09-2020 BMJ Publishing Group
Series:	Original research
Subjects:	Adolescent Adult Algorithms Arthritis Blood pressure Cardiovascular disease Cardiovascular Diseases - diagnosis Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Cholesterol Cost control Cost Savings Cost-Benefit Analysis Dementia Diabetes Disease prevention England - epidemiology Health Economics Heart Disease Risk Factors Humans Hypertension Intervention Ischemia Lifestyles Metabolism Osteoarthritis Public health Risk Factors Stroke England United Kingdom > UK stroke medicine cardiology public health preventive medicine health economics
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Summary:	To estimate the cost savings and health benefits of improving detection of individuals at high risk of cardiovascular disease (CVD) in England, to determine to which patient subgroups these benefits arise, and to compare different strategies for subsequent management. An economic analysis using the School for Public Health Research CVD Prevention Model. England 2018. Adults aged 16 and older with one or more high cardiovascular risk conditions, including hypertension, diabetes, non-diabetic hyperglycaemia, atrial fibrillation, chronic kidney disease and high cholesterol. Detection of 100% of individuals with CVD high risk conditions compared with current levels of detection in England. Detected individuals are assumed to be managed either according to current levels of care or National Institute of Health and Care Excellence (NICE) guidelines. Incremental and cumulative costs, savings, quality adjusted life years (QALYs), CVD cases, and net monetary benefit, from a UK NHS and Personal Social Services perspective. £68 billion could be saved, 4.9 million QALYs gained and 3.4 million cases of CVD prevented over 25 years if all individuals in England with the six CVD high risk conditions were diagnosed and subsequently managed at current levels. Additionally, if all detected individuals were managed according to NICE guidelines, total savings would be £61 billion, 8.1 million QALYs would be gained and 5.2 million CVD cases prevented. Most benefits come from detection of high cholesterol in the short term and diabetes in the long term. Substantial cost savings and health benefits would accrue if all individuals with conditions that increase CVD risk could be diagnosed, with detection of undiagnosed diabetes producing greatest benefits. Ensuring all conditions are managed according to NICE guidelines would further increase health benefits. Projected cost-savings could be invested in developing acceptable and cost-effective solutions for improving detection and management.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2020-037486