Table 4.
Lifetime costs, health gain and cost-effectiveness of cardiovascular disease prevention in Australia
| Lifetime health gain (QALYs) | Lifetime intervention costs to Government ($billion) | Lifetime intervention costs to Patients ($billion) | Lifetime treatment costs averted ($billion) | Cost-effectiveness* ($/QALY) | |
|---|---|---|---|---|---|
| Current practice |
270,000 (220,000 to 310,000) |
$12 ($12 to $12) |
$2.6 ($2.6 to $2.6) |
-$3.4 (−$4.4 to -$2.4) |
$41,000 ($34,000 to $52,000) |
| Existing single risk factor-based guidelines |
180,000 (120,000 to 240,000) |
$7.4 ($5.1 to $9.9) |
$3.5 ($2.4 to $4.7) |
-$2.3 (−$3.4 to -$1.3) |
$49,000 ($40,000 to $60,000) |
| Absolute risk (≥15%) |
67,000 (44,000 to 91,000) |
$1.3 ($0.9 to $1.8) |
$0.8 ($0.5 to $1.0) |
-$0.7 (−$1.0 to -$0.4) |
$21,000 ($17,000 to $26,000) |
| Absolute risk (≥10%) |
150,000 (97,000 to 200,000) |
$3.5 ($2.4 to $4.6) |
$1.9 ($1.3 to $2.6) |
-$1.5 (−$2.3 to -$0.9) |
$27,000 ($22,000 to $32,000) |
| Absolute risk (≥5%) | |||||
| – including statins <10% |
330,000 (220,000 to 450,000) |
$10.0 ($7.0 to $14.0) |
$5.5 ($3.8 to $7.4) |
-$3.7 (−$5.7 to -$2.2) |
$37,000 ($31,000 to $44,000) |
| – excluding statins <10% |
290,000 (190,000 to 390,000) |
$6.5 ($4.5 to $8.6) |
$4.3 ($2.9 to $5.7) |
-$3.2 (−$4.8 to -$1.9) |
$27,000 ($21,000 to $33,000) |
| Absolute risk (≥5%) assuming the cheaper price of statins in New Zealand | |||||
| – including statins <10% |
330,000 (220,000 to 450,000) |
$5.1 ($3.5 to $6.8) |
$3.7 ($2.6 to $5.0) |
-$3.7 (−$5.7 to -$2.2) |
$16,000 ($12,000 to $20,000) |
| – excluding statins <10% | 290,000 (190,000 to 390,000) | $4.7 ($3.3 to $6.3) | $3.6 ($2.5 to $4.8) | -$3.2 (−$4.8 to -$1.9) | $18,000 ($14,000 to $24,000) |
NB. All values are rounded to two significant figures. Health gains and costs are presented as mean and 95% uncertainty interval, and cost-effectiveness ratio as median and 95% uncertainty interval. Costs are presented in 2008 Australian dollars. QALY – quality-adjusted life year*. A value of $50,000/QALY is often considered a threshold for cost-effectiveness in Australia.