[Coronary disease and social security. A simulation model on cost analysis]

Area of Science:

• Health Economics
• Cardiovascular Disease Research
• Public Health Policy

Background:

• Coronary heart disease (CHD) poses a significant economic burden on social security systems.
• Hypercholesteremia is a key risk factor for developing CHD.
• Accurate cost assessment is crucial for effective public health interventions and resource allocation.

Purpose of the Study:

• To develop a Monte Carlo simulation model for assessing 10-year social security costs of CHD in Germany.
• To compare costs between a population with existing CHD and one developing CHD over 10 years.
• To analyze the impact of hypercholesteremia on CHD-related social security expenditures.

Main Methods:

• Utilized a Monte Carlo simulation model to estimate costs from a social security perspective.
• Incorporated data from the German Cardiovascular Prevention Trial (DHP).
• Simulated two submodels: pre-existing CHD and developing CHD from hypercholesteremia.

Main Results:

• Cumulative 10-year social security costs for CHD in the 45-65 age group estimated at approximately 59 billion DM (existing CHD).
• Estimated costs approximately 41 billion DM if CHD develops over the 10-year period.
• Sensitivity analyses indicated high sensitivity to assumptions regarding direct costs per case/year.

Conclusions:

• The model provides a comprehensive social security perspective on CHD costs, revealing interdependencies within the system.
• The financial implications of CHD are substantial, necessitating targeted prevention and management strategies.
• The model's transparency regarding social security interactions offers valuable insights for policymakers.