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Cost effectiveness of a general practice chronic disease management plan for coronary heart disease in Australia

Derek P Chew1, Robert Carter, Bree Rankin

  • 1Flinders Medical Centre, Flinders University, Flinders Drive, Bedford Park, SA 5042, Australia. derek.chew@flinders.edu.au

Australian Health Review : a Publication of the Australian Hospital Association
|May 26, 2010
PubMed

Insights

A new Australian program for coronary heart disease (CHD) management in general practice is likely cost-effective. This approach optimizes current therapies, offering substantial benefits to the community.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Preventive Cardiology

Background:

  • The cost-effectiveness of general practice-based coronary heart disease (CHD) management programs in Australia is not well-established.
  • Existing management strategies for CHD patients require economic evaluation within the Australian healthcare context.

Purpose of the Study:

  • To evaluate the economic viability of a secondary prevention program for CHD patients managed in Australian general practice.
  • To determine the incremental cost-effectiveness ratio (ICER) of an optimized CHD management program.

Main Methods:

  • An economic model was developed to assess a secondary prevention program.
  • The program involved clinical assessment, pharmacotherapy optimization, lifestyle modification, a disease registry, and financial incentives.
  • Cost-effectiveness was measured using the ICER in Australian dollars per disability-adjusted life year (DALY) prevented.

Main Results:

  • In 2006, CHD accounted for 263,487 DALYs in Australia.
  • The proposed program estimated an annual cost of $115,650,000.
  • With a 15% reduction in mortality/disability and 40% uptake, the ICER was $8081 per DALY prevented; sensitivity analysis yielded up to $38,316 per DALY.

Conclusions:

  • Current CHD therapies offer proven benefits for reducing morbidity and mortality.
  • A general practice-based program effectively applying these therapies is likely cost-effective.
  • Such a program promises significant and sustainable advantages for the Australian community.
Abstract

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