DEVELOPING A MULTI-COUNTRY MICROSIMULATION TO ESTIMATE THE FUTURE IMPACT OF GUIDELINE-DIRECTED MEDICAL THERAPY ON POTENTIALLY AVOIDABLE HOSPITALISATIONS AND RELATED ECONOMIC, SOCIETAL, AND ENVIRONMENTAL OUTCOMES: GLOBALPAH
Author(s)
Sara Allin, PhD1, Marc Bains, BA2, Katherine De Bienassis, MPH3, Stephen J. Greene, PhD4, Gundula Koblmiller, MSc5, Elias Mossialos, PhD6, Richard EK Russell, PhD7, Kelly Saldana, MSc8, York Francis Zoellner, PhD9, Laura Webber, PhD10, Lise Retat, PhD11, Dale Payne, BA12, Maxim Davis, PhD13, 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, 5Austrian Lung Union, 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, United Kingdom, 11BioPharmaceuticals Medical, AstraZeneca, Barcelona, Spain, 12BioPharmaceuticals Medical, AstraZeneca, Mississauga, ON, Canada, 13HealthLumen Limited, 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, 5Austrian Lung Union, 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, United Kingdom, 11BioPharmaceuticals Medical, AstraZeneca, Barcelona, Spain, 12BioPharmaceuticals Medical, AstraZeneca, Mississauga, ON, Canada, 13HealthLumen Limited, London, United Kingdom, 14BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
OBJECTIVES: For millions of patients, failure to adhere to and be prescribed Guideline-Directed Medical Therapy (GDMT) results in preventable hospitalisations, lost productivity, and reduced quality of life. An individual-level microsimulation model quantifies the impact of current and optimised GDMT scenarios on potentially avoidable hospitalisations (PAHs) and related outcomes over time.
METHODS: GlobalPAH is a novel and flexible microsimulation model integrating newly developed GDMT implementation modules while retaining principles from a previously validated framework. It quantifies the impact of current vs. optimised GDMT scenarios, connecting disease onset and progression to healthcare resource use (HCRU), healthcare costs, macroeconomic, societal (caregiver burden), and environmental (CO2 emissions) outcomes to support policy decision-making across five diseases (chronic obstructive pulmonary disease, asthma, hypertension, heart failure, diabetes) in 12 countries. Four modules: population, epidemiology, treatment and outcomes, underpin synthetic populations of over 50 million individuals per country. Individuals are generated through probabilistic sampling calibrated to national demographic data, capturing heterogeneity in age, sex, risk factors, comorbidities, and treatment status. Individuals are tracked through annual health-state transitions informed by disease-specific epidemiological studies and national health data. Projections are generated over 2-, 4-, 10-, and 25-year time horizons. A global Steering Committee of clinicians, economists, and policy experts peer-reviewed assumptions and study design. Internal and external validation are embedded throughout, with proxy methodologies applied where data availability is fragmented. Sensitivity analyses on key parameters are conducted.
RESULTS: The model produces country-specific projections of hospitalisations, HCRU, health and macroeconomic costs, quality-of-life, societal impacts and environmental consequences under current versus optimised GDMT uptake. Using the Netherlands as the pilot country, external validation confirmed baseline projections within 5.3% of observed hospitalisation rates.
CONCLUSIONS: GlobalPAH provides a scalable, modular microsimulation framework for estimating the population-level and health-system consequences of improved GDMT implementation. It supports cross-country scenario analyses intended to inform health-system planning, resource allocation, and investment cases.
METHODS: GlobalPAH is a novel and flexible microsimulation model integrating newly developed GDMT implementation modules while retaining principles from a previously validated framework. It quantifies the impact of current vs. optimised GDMT scenarios, connecting disease onset and progression to healthcare resource use (HCRU), healthcare costs, macroeconomic, societal (caregiver burden), and environmental (CO2 emissions) outcomes to support policy decision-making across five diseases (chronic obstructive pulmonary disease, asthma, hypertension, heart failure, diabetes) in 12 countries. Four modules: population, epidemiology, treatment and outcomes, underpin synthetic populations of over 50 million individuals per country. Individuals are generated through probabilistic sampling calibrated to national demographic data, capturing heterogeneity in age, sex, risk factors, comorbidities, and treatment status. Individuals are tracked through annual health-state transitions informed by disease-specific epidemiological studies and national health data. Projections are generated over 2-, 4-, 10-, and 25-year time horizons. A global Steering Committee of clinicians, economists, and policy experts peer-reviewed assumptions and study design. Internal and external validation are embedded throughout, with proxy methodologies applied where data availability is fragmented. Sensitivity analyses on key parameters are conducted.
RESULTS: The model produces country-specific projections of hospitalisations, HCRU, health and macroeconomic costs, quality-of-life, societal impacts and environmental consequences under current versus optimised GDMT uptake. Using the Netherlands as the pilot country, external validation confirmed baseline projections within 5.3% of observed hospitalisation rates.
CONCLUSIONS: GlobalPAH provides a scalable, modular microsimulation framework for estimating the population-level and health-system consequences of improved GDMT implementation. It supports cross-country scenario analyses intended to inform health-system planning, resource allocation, and investment cases.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD108
Topic
Health Service Delivery & Process of Care, Study Approaches