MICROSIMULATION-BASED COST EFFECTIVENESS ANALYSIS OF INTEGRATED CARDIOMETABOLIC HEALTH SCREENING IN THE UNITED KINGDOM, GERMANY, FRANCE, AND AUSTRALIA
Author(s)
Georgios Xydopoulos, PhD1, Fiona Adshead, MSc2, Alexandre Babin, MSc3, Amitava Banerjee, MA, MPH, DPhil, PGCert4, Bruno DETOURNAY, MA, MBA, MSc, MD5, Jaimie Espin, MSc, PhD6, Ines Hassan7, Matt Kearney, MPH, MD8, Jan T. Kielstein, MD9, Koichiro Kuwahara, MD, PhD10, Carel le Roux, MD, PhD11, Nirosha Lederer, PhD12, Lise RETAT, PhD13, Scott B. Robinson, MA, MPH14, Vasileios Vasilopoulos, MSc15, Juergen Wasem, PhD16, Clélia-Elsa Froguel, BA Pgd17;
1ZS Associates, Cambridge, United Kingdom, 2Sustainable Healthcare Coalition, London, United Kingdom, 3Renaloo, Paris, France, 4University College London Hospitals, London, United Kingdom, 5CEMKA, Antony, France, 6EASP, Granada, Spain, 7London, United Kingdom, 8CVD Action, London, United Kingdom, 9Universität Braunschweig, Braunschweig, Germany, 10Shinshu University School of Medicine, Matsumoto, Japan, 11University College Dublin, Dublin, Ireland, 12AstraZeneca, Washington, DC, USA, 13AstraZeneca, Barcelona, Spain, 14ZS Associates, Durham, NC, USA, 15ZS Associates, London, United Kingdom, 16University Duisburg, Essen, Germany, 17AstraZeneca, Cambridge, United Kingdom
1ZS Associates, Cambridge, United Kingdom, 2Sustainable Healthcare Coalition, London, United Kingdom, 3Renaloo, Paris, France, 4University College London Hospitals, London, United Kingdom, 5CEMKA, Antony, France, 6EASP, Granada, Spain, 7London, United Kingdom, 8CVD Action, London, United Kingdom, 9Universität Braunschweig, Braunschweig, Germany, 10Shinshu University School of Medicine, Matsumoto, Japan, 11University College Dublin, Dublin, Ireland, 12AstraZeneca, Washington, DC, USA, 13AstraZeneca, Barcelona, Spain, 14ZS Associates, Durham, NC, USA, 15ZS Associates, London, United Kingdom, 16University Duisburg, Essen, Germany, 17AstraZeneca, Cambridge, United Kingdom
OBJECTIVES: Cardiovascular, renal, and metabolic (CVRM) diseases are clinically interdependent, yet policies addressing these conditions are often developed in isolation, limiting overall effectiveness. The objective of this study was to develop an epidemiologic and economic model to estimate the clinical, economic, societal and environmental impact of integrated cardiometabolic health screening programs in Australia, France, Germany and the UK, with the aim of informing policy recommendations.
METHODS: A discrete-time, patient-level microsimulation model was constructed to evaluate the impact of cardiometabolic health screening to assess screening effects on disease progression and healthcare resource use/costs. Inputs were derived from a targeted literature review and a steering committee. Dynamic risk equations, multimorbidity interactions, and annual health-state transitions were incorporated within synthetic, nationally representative cohorts. Outcomes included clinical events avoided, cost savings, and societal/environmental benefits.
RESULTS: Integrated cardiometabolic health screening facilitated earlier detection of cardiovascular risk, reduced acute events, and lowered long-term healthcare costs. Initial results from the UK show that expanding health checks to include CVRM comorbid and multimorbid patients is projected to reduce progression to end-stage kidney disease by 2.4% and overall mortality by 1.2%, improving outcomes and easing system burden. Earlier diagnostics for Heart Failure (HF) and Chronic Kidney Disease (CKD) (i.e NT-proBNP and uACR with eGFR) are estimated to lower annual healthcare spending by 27.3%, through earlier diagnostics and access to guideline-directed therapy. Screening programs covering interconnected CVRM conditions are anticipated to reduce absenteeism related costs by 14%. Reduced healthcare utilization in hypertension, CKD, HF, type 2 diabetes, obesity, and dyslipidemia is projected to cut CO₂ emissions by 14%.
CONCLUSIONS: Integrated cardiometabolic health screening delivers substantial national-level benefits, including improved outcomes, reduced expenditures, increased productivity, and environmental gains compared to current standard of care. Microsimulation modeling provides a robust framework for evaluating multi-country strategies and guiding policy decisions.
METHODS: A discrete-time, patient-level microsimulation model was constructed to evaluate the impact of cardiometabolic health screening to assess screening effects on disease progression and healthcare resource use/costs. Inputs were derived from a targeted literature review and a steering committee. Dynamic risk equations, multimorbidity interactions, and annual health-state transitions were incorporated within synthetic, nationally representative cohorts. Outcomes included clinical events avoided, cost savings, and societal/environmental benefits.
RESULTS: Integrated cardiometabolic health screening facilitated earlier detection of cardiovascular risk, reduced acute events, and lowered long-term healthcare costs. Initial results from the UK show that expanding health checks to include CVRM comorbid and multimorbid patients is projected to reduce progression to end-stage kidney disease by 2.4% and overall mortality by 1.2%, improving outcomes and easing system burden. Earlier diagnostics for Heart Failure (HF) and Chronic Kidney Disease (CKD) (i.e NT-proBNP and uACR with eGFR) are estimated to lower annual healthcare spending by 27.3%, through earlier diagnostics and access to guideline-directed therapy. Screening programs covering interconnected CVRM conditions are anticipated to reduce absenteeism related costs by 14%. Reduced healthcare utilization in hypertension, CKD, HF, type 2 diabetes, obesity, and dyslipidemia is projected to cut CO₂ emissions by 14%.
CONCLUSIONS: Integrated cardiometabolic health screening delivers substantial national-level benefits, including improved outcomes, reduced expenditures, increased productivity, and environmental gains compared to current standard of care. Microsimulation modeling provides a robust framework for evaluating multi-country strategies and guiding policy decisions.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE426
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Urinary/Kidney Disorders