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

Chew, Derek P., Carter, Robert, Rankin, Bree, Boyden, Andrew and Egan, Helen 2010, Cost effectiveness of a general practice chronic disease management plan for coronary heart disease in Australia, Australian health review, vol. 34, no. 2, pp. 162-169.

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Title Cost effectiveness of a general practice chronic disease management plan for coronary heart disease in Australia
Author(s) Chew, Derek P.
Carter, Robert
Rankin, Bree
Boyden, Andrew
Egan, Helen
Journal name Australian health review
Volume number 34
Issue number 2
Start page 162
End page 169
Total pages 8
Publisher CSIRO Publishing
Place of publication Collingwood, Vic.
Publication date 2010
ISSN 0156-5788
1449-8944
Keyword(s) coronary heart disease management programs
coronary heart disease prevention
Summary Background. The cost effectiveness of a general practice-based program for managing coronary heart disease (CHD) patients in Australia remains uncertain. We have explored this through an economic model.

Methods. A secondary prevention program based on initial clinical assessment and 3 monthly review, optimising of pharmacotherapies and lifestyle modification, supported by a disease registry and financial incentives for quality of care and outcomes achieved was assessed in terms of incremental cost effectiveness ratio (ICER), in Australian dollars per disability adjusted life year (DALY) prevented.

Results. Based on 2006 estimates, 263 487 DALYs were attributable to CHD in Australia. The proposed program would add $115 650 000 to the annual national heath expenditure. Using an estimated 15% reduction in death and disability and a 40% estimated program uptake, the program’s ICER is $8081 per DALY prevented. With more conservative estimates of effectiveness and uptake, estimates of up to $38 316 per DALY are observed in sensitivity analysis.

Conclusions. Although innovation in CHD management promises improved future patient outcomes, many therapies and strategies proven to reduce morbidity and mortality are available today. A general practice-based program for the optimal application of current therapies is likely to be cost-effective and provide substantial and sustainable benefits to the Australian community.

What is known about this topic? Chronic disease management programs are known to provide gains with respect to reductions in death and disability among patients with coronary heart disease. The cost effectiveness of such programs in the Australian context is not known.

What does this paper add? This paper suggests that implementing a coronary heart disease program in Australia is highly cost-effective across a broad range of assumptions of uptake and effectiveness.

What are the implications for practitioners? These data provide the economic rationale for the implementation of a chronic disease management program with a disease registry and regular review in Australia.
Notes Reproduced with the kind permission of the copyright owner.
Language eng
Field of Research 140208 Health Economics
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2010, AHHA
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047355

Document type: Journal Article
Collections: Population Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.