COST-EFFECTIVENESS OF OPTIMISING POST-DISCHARGE CARE FOR CORONARY HEART DISEASE WITH TYPE 2 DIABETES
Author(s)
Sangita Shakya, MPH1, Sean Randall, PhD1, Suzanne. Robinson, PhD1, Crystal Man Ying Lee, PhD1, Bernard Kwadwo Yeboah Asiamah-Asare, PhD1, James Boyd, PhD2, Richard Varhol, Msc3, Lan Gao, PhD, MMed1.
1Deakin Health Economics, Deakin University, Melbourne, VIC, Australia, 2School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia, 3School of Population Health, Curtin University, Perth, WA, Australia.
1Deakin Health Economics, Deakin University, Melbourne, VIC, Australia, 2School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia, 3School of Population Health, Curtin University, Perth, WA, Australia.
OBJECTIVES: Coronary heart disease (CHD) with type 2 diabetes (T2DM) represents a high-risk population with high healthcare utilisation and poor health outcomes. Strengthening secondary prevention strategies through structured general practice (GP) follow-up may improve outcomes; however, economic evidence remains limited. This study evaluates the cost-effectiveness of optimising structured GP follow-up after a CHD event, compared with current practice, using real-world data.
METHODS: A modelled cost-effectiveness study was conducted from the Australian healthcare perspective. A Markov model was developed using general practice and hospital-linked administrative data from Western Australia to inform transition probabilities and healthcare costs for patients with CHD and T2DM. Utility values for calculating Quality-adjusted life years (QALYs) were obtained from published sources. Incremental cost-effectiveness ratio (ICER), expressed as cost per QALY gained, was calculated for optimised structured GP follow-up (1-2 GP visits per month for 1 year) post-CHD event compared with current practice. Base-case analysis simulated a cohort with CHD and T2DM with a mean age of 65 years over a 30-year time horizon. Uncertainty was evaluated with deterministic and probabilistic sensitivity analysis (PSA). Future costs and effects were discounted at 5% annually.
RESULTS: The optimised structured GP follow-up generated both higher costs (AU$640.14) and greater benefits (0.0195 QALYs) per patient, resulting in an ICER of AU$32,874 per QALY gained over a 30-year period. Sensitivity analysis supported the robustness of the base-case results, with 88.4% of simulated ICERs falling below the commonly quoted Australian willingness-to-pay threshold of AU$50,000 per QALY.
CONCLUSIONS: Increased structured GP follow-up among patients with CHD and T2DM is likely to be a cost-effective strategy in the Australian context. These findings highlight that modest, scalable improvements in the uptake of structured GP follow-up within existing primary healthcare systems could yield meaningful healthcare gains at acceptable costs.
METHODS: A modelled cost-effectiveness study was conducted from the Australian healthcare perspective. A Markov model was developed using general practice and hospital-linked administrative data from Western Australia to inform transition probabilities and healthcare costs for patients with CHD and T2DM. Utility values for calculating Quality-adjusted life years (QALYs) were obtained from published sources. Incremental cost-effectiveness ratio (ICER), expressed as cost per QALY gained, was calculated for optimised structured GP follow-up (1-2 GP visits per month for 1 year) post-CHD event compared with current practice. Base-case analysis simulated a cohort with CHD and T2DM with a mean age of 65 years over a 30-year time horizon. Uncertainty was evaluated with deterministic and probabilistic sensitivity analysis (PSA). Future costs and effects were discounted at 5% annually.
RESULTS: The optimised structured GP follow-up generated both higher costs (AU$640.14) and greater benefits (0.0195 QALYs) per patient, resulting in an ICER of AU$32,874 per QALY gained over a 30-year period. Sensitivity analysis supported the robustness of the base-case results, with 88.4% of simulated ICERs falling below the commonly quoted Australian willingness-to-pay threshold of AU$50,000 per QALY.
CONCLUSIONS: Increased structured GP follow-up among patients with CHD and T2DM is likely to be a cost-effective strategy in the Australian context. These findings highlight that modest, scalable improvements in the uptake of structured GP follow-up within existing primary healthcare systems could yield meaningful healthcare gains at acceptable costs.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE4
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)