QUANTIFYING THE FUTURE HEALTH, ECONOMIC, SOCIETAL, AND ENVIRONMENTAL IMPACT OF OPTIMISED GUIDELINE-DIRECTED MEDICAL THERAPY ON POTENTIALLY AVOIDABLE HOSPITALISATIONS ACROSS MULTIPLE COUNTRIES: THE GLOBALPAH PROGRAM
Author(s)
Sara Allin, PhD1, Marc Bains, BA2, Katherine De Bienassis, MSc3, Stephen J. Greene, PhD4, Gundula Koblmiller, MSc5, Elias Mossialos, PhD6, Richard EK Russell, PhD7, Kelly Saldana, MPH8, York Francis Zoellner, PhD9, Laura Webber, PhD10, Dale Payne, BA11, Lise RETAT, PhD12, Joshua Alexander Card-Gowers, MSc13, Nirosha Lederer, PhD14.
1University of Toronto, Toronto, ON, Canada, 2HeartLife Foundation, Vancouver, BC, Canada, 3Organisation for Economic Co-operation and Development (OECD), Paris, France, 4Duke University, Durham, NC, USA, 5Gundula Koblmiller Consulting & Coaching, Vienna, Austria, 6London School of Economics -LSE Health, London, United Kingdom, 7King's College London, London, United Kingdom, 8ISPOR, Lawrenceville, NJ, USA, 9Hamburg University of Applied Sciences, Hamburg, Germany, 10COO, HealthLumen Limited, London, AL, USA, 11BioPharmaceuticals Medical, AstraZeneca, Mississauga, ON, Canada, 12BioPharmaceuticals Medical, AstraZeneca Spain, Barcelona, Spain, 13Healthlumen, London, United Kingdom, 14BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
1University of Toronto, Toronto, ON, Canada, 2HeartLife Foundation, Vancouver, BC, Canada, 3Organisation for Economic Co-operation and Development (OECD), Paris, France, 4Duke University, Durham, NC, USA, 5Gundula Koblmiller Consulting & Coaching, Vienna, Austria, 6London School of Economics -LSE Health, London, United Kingdom, 7King's College London, London, United Kingdom, 8ISPOR, Lawrenceville, NJ, USA, 9Hamburg University of Applied Sciences, Hamburg, Germany, 10COO, HealthLumen Limited, London, AL, USA, 11BioPharmaceuticals Medical, AstraZeneca, Mississauga, ON, Canada, 12BioPharmaceuticals Medical, AstraZeneca Spain, Barcelona, Spain, 13Healthlumen, London, United Kingdom, 14BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
OBJECTIVES: Suboptimal uptake and adherence to guideline-directed medical therapy (GDMT) means significant gains in health outcomes and efficiencies are unrealised. This study projected the healthcare resource use (HCRU) associated with 5 diseases: chronic obstructive pulmonary disease, asthma, hypertension, heart failure, and diabetes, and quantified the system-level impact of increasing uptake and adherence of GDMT to 100%.
METHODS: To inform policy-making, an individual-level microsimulation model projected nationally representative populations (Austria, Canada, China, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, UK, US) over 10-years, 2026-2035. The model comprises four modules: demographics, epidemiology, treatment, and outcomes. Individuals were characterised by dynamic profiles, including disease stage, comorbidities, and risk factors. Two scenarios were compared: current GDMT, defined by real-world prescription fill rates; and optimal GDMT, defined by a theoretical maximum 100% uptake and adherence. Outcomes included disease burden, hospitalisations, HCRU, costs; caregiver burden, quality of life, macroeconomic, and environmental impacts. A steering committee reviewed assumptions.
RESULTS: Over 10-years, disease-specific hospitalisations are projected to rise by 19.6% in Netherlands, and 9.00% in Spain. Achieving 100% GDMT would avert 0.11M hospitalisations by 2030 and 0.24M by 2035 in Netherlands; 0.48M by 2030 and 0.97M by 2035 in Spain. By 2035, complete GDMT reduced inpatient bed days by 1.56M (735,000 by 2030), hospitalisation costs by €1.05B (€543M by 2030), and productivity losses by €1.05B (81.7M by 2030) in Netherlands; and 8.12M fewer bed days (3.99M by 2030), €5.76B lower hospitalisation costs (€3.08B by 2030), €75.2M in productivity gains (€40.7M by 2030) in Spain. Other country results and outcomes are forthcoming.
CONCLUSIONS: Suboptimal GDMT uptake is a major, modifiable driver of avoidable hospitalisations. Optimising GDMT across multiple chronic conditions would help more patients maintain disease control, delivering large-scale short- and long-term reductions in hospital burden, hospital costs and productivity multi-nationally, representing a high-impact opportunity to strengthen health system capacity, improving patient outcomes.
METHODS: To inform policy-making, an individual-level microsimulation model projected nationally representative populations (Austria, Canada, China, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, UK, US) over 10-years, 2026-2035. The model comprises four modules: demographics, epidemiology, treatment, and outcomes. Individuals were characterised by dynamic profiles, including disease stage, comorbidities, and risk factors. Two scenarios were compared: current GDMT, defined by real-world prescription fill rates; and optimal GDMT, defined by a theoretical maximum 100% uptake and adherence. Outcomes included disease burden, hospitalisations, HCRU, costs; caregiver burden, quality of life, macroeconomic, and environmental impacts. A steering committee reviewed assumptions.
RESULTS: Over 10-years, disease-specific hospitalisations are projected to rise by 19.6% in Netherlands, and 9.00% in Spain. Achieving 100% GDMT would avert 0.11M hospitalisations by 2030 and 0.24M by 2035 in Netherlands; 0.48M by 2030 and 0.97M by 2035 in Spain. By 2035, complete GDMT reduced inpatient bed days by 1.56M (735,000 by 2030), hospitalisation costs by €1.05B (€543M by 2030), and productivity losses by €1.05B (81.7M by 2030) in Netherlands; and 8.12M fewer bed days (3.99M by 2030), €5.76B lower hospitalisation costs (€3.08B by 2030), €75.2M in productivity gains (€40.7M by 2030) in Spain. Other country results and outcomes are forthcoming.
CONCLUSIONS: Suboptimal GDMT uptake is a major, modifiable driver of avoidable hospitalisations. Optimising GDMT across multiple chronic conditions would help more patients maintain disease control, delivering large-scale short- and long-term reductions in hospital burden, hospital costs and productivity multi-nationally, representing a high-impact opportunity to strengthen health system capacity, improving patient outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD59
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas