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Costs and cost effectiveness of cardiovascular screening and intervention: the British family heart study
D Wonderling1, C McDermott, M Buxton
1Health Economics Research Group, Brunel University, Uxbridge, Middlesex.
Insights
The British family heart study
Area of Science:
- Cardiovascular health
- Health economics
- Preventive medicine
Background:
- Cardiovascular diseases pose a significant public health challenge.
- Effective screening and intervention programs are crucial for managing cardiovascular risk.
- The British Family Heart Study aimed to evaluate a novel cardiovascular program.
Purpose of the Study:
- To determine the costs associated with the British Family Heart Study's cardiovascular screening and intervention program.
- To assess the cost-effectiveness of this family-centered, nurse-led intervention.
Main Methods:
- A cost-effectiveness analysis was conducted using data from a randomized controlled trial.
- Clinical and resource utilization data were sourced from the trial, with unit costs from external estimates.
- The study involved 13 general practices across Britain, including 4185 men and 2827 partners.
Main Results:
- The estimated annual cost of the program was £63 per person.
- Short-term costs to the National Health Service (NHS) were £77 per man and £13 per woman.
- The cost per 1% reduction in coronary risk was approximately £5.08 for men and £5.78 for women.
Conclusions:
- The direct program cost for a practice of 7500 patients was approximately £58,000 annually.
- NHS costs varied, potentially increasing for men but decreasing for women due to resource utilization.
- The program demonstrated a cost-effective approach to cardiovascular risk reduction.
Objective:
To measure costs and cost effectiveness of the British family heart study cardiovascular screening and intervention programme.
Design:
Cost effectiveness analysis of randomised controlled trial. Clinical and resource use data taken from trial and unit cost data from external estimates.
Setting:
13 general practices across Britain.
Subjects:
4185 men aged 40-59 and their 2827 partners.
Intervention:
Nurse led programme using a family centered approach, with follow up according to degree of risk.
Main Outcome Measures:
Cost of the programme it self; overall short term cost to NHS; cost per 1% reduction in coronary risk at one year.
Results:
Estimated cost of putting the programme into practice for one year was 63 pounds per person (95% confidence interval 60 pounds to 65 pounds). The overall short term cost to the health service was 77 pounds per man (29 pounds to 124 pounds) but only 13 pounds per woman (-48 pounds to 74 pounds), owing to differences in utilisation of other health service resources. The cost per 1% reduction in risk was 5.08 pounds per man (5.92 pounds including broader health service costs) and 5.78 pounds per woman (1.28 pounds taking into account wider health service savings).
Conclusions:
The direct cost of the programme to a four partner practice of 7500 patients would be approximately 58,000 pounds. Annually, 8300 pounds would currently be paid to a practice of this size working to the maximum target on the health promotion bands, plus any additional reimbursement of practice staff salaries for which the practice qualified. The broader short term costs to the NHS may augment these costs for men but offset them considerably for women.