Table 1. Summary of model inputs.
| Data | Sources | |
|---|---|---|
| Baseline mortality and risk of cardiovascular disease | ||
| Probability of stroke (10 years) | 0.7–6.2%(age and sex dependent) | Calculated with Framingham [15,16] and risk factor profile based on patient level data |
| Probability of MI (10 years) | 1.1–9.4% (age and sex dependent) | |
| Probability of angina (10 years) | 1.5–13.3%(age and sex dependent) | |
| Probability of heart failure (10 years) | 0.4–3.9%(age and sex dependent) | |
| Probability of PVD (10 years) | 0.7–6.2% %(age and sex dependent) | |
| Assumed distribution of possible CV events within 10 year CV risk | ||
| Stroke | 16% | D’Agostino (2008) [16] Wood (2004) [24] |
| Myocardial infarction | 24% | |
| Angina | 34% | |
| Heart failure | 10% | |
| PVD | 16% | |
| Risk reduction with statins | ||
| Stroke | 0.80 (95% CI 0.73–0.86) | CTT (2005),[22] HPS (2002)[23] |
| MI, HF, angina | 0.72 (95% CI 0.69–0.76) | CTT (2005), HPS (2002) |
| PVD | 0.85 (95% CI 0.75–0.95) | HPS (2002) |
| Probability of death from event | ||
| Fatal stroke | 0.19 | Ward (2007)[25] |
| Fatal MI | 0.19–0.36 (Men) | Ward (2007) |
| 0.23–0.40 (Women) | ||
| Fatal heart failure | 0.17 (r = 68, n = 396) | Mehta (2009) [26] |
| SMR after stroke | 2.72 (95% CI 2.59–2.85) | Bronnum-Hansen (2001) [27] |
| SMR after MI | 2.68 (95% CI 2.48–2.91) | Bronnum-Hansen (2001) [28] |
| SMR after Heart Failure | 2.17 (95% CI 1.96–2.41) | de Guili (2005) [29] |
| SMR after Angina | 2.19 (95% CI 2.05–2.33) | NCGC [30] |
| SMR after PVD | 2.44 (95% CI 1.59–3.74) | Leng (1996) [31] |
| Reduction in blood pressure | ||
| Number of AHT drugs required to achieve target BP | 0.60–1.52 | Law (2009)[21] |
| Reduction in CV risk with reduction in BP | ||
| Polypill | ||
| CHD risk | 10–52% | Law (2009) |
| Stroke risk | 14–65% | Law (2009) |
| PVD risk | 13–23% | Murabito (1997)[32] |
| (Dependent on age, sex and risk group) | ||
| Treat to target | ||
| CHD risk | 15–37% | Law (2009) |
| Stroke risk | 20–47% | Law (2009) |
| PVD risk | 13–32% | Murabito (1997) |
| (Dependent on age, sex and risk group) | ||
| Polypill adherence | 84% | TIPS (2009)[20] |
| Utilities | ||
| No cardiovascular event | (age and sex dependent) | General population utilities from EQ-5D (UK Tariff) (NCSR, 2006)[33] |
| Death | 0 | By definition |
| Quality of life multipliers | ||
| Acute MI | 0.76 (0.018) | Cooper (2008)[18], NICE (2014) [34] |
| Post MI | 0.88 (0.018) | As above |
| Acute angina | 0.77 (0.038) | As above |
| Post-acute angina | 0.88 (0.018) | As above |
| Heart failure | 0.68 (0.020) | As above |
| Stroke | 0.63 (0.040) | As above |
| PVD | 0.90 (0.020) | As above |
| Costs | ||
| £ per year | ||
| Simvastatin 40mg | 15.26 | BNF March 2013 [35] |
| Amlodopine 5mg | 12.13 | BNF March 2013 |
| Indapamide 2.5mg | 11.87 | BNF March 2013 |
| Ramipril 5mg | 18.13 | BNF March 2013 |
| Polypill | 171 | Assumed same price as Trinomia |
| Unit cost £ | ||
| Blood test | 15 | Ward (2007) |
| GP visit | 33 | Curtis (2012) [36] |
| Practice nurse visit | 11.25 | Curtis (2012) |
| Acute events: | One-off cost £ | |
| Stroke | 11,020 | Youman (2003) [37] |
| MI | 5,487 | Palmer (2002) [38] |
| Angina | 3,292 | Assumed 60% of MI cost |
| PVD | 1,971 | NHS Reference costs 2011/12 [39] |
| Heart failure | 2,699 | NHS Reference costs 2011/12 |
| Long-term costs | £ per year | |
| Stroke | 2721 | Youman (2003) |
| MI | 572 | Cooper (2008) [18] |
| Angina | 572 | Cooper (2008) |
| PVD | 302 | Cooper (2008) |
| Heart failure | 572 | Cooper (2008) |
SMR: Standardised Mortality Ratio; MI: Myocardial infarction; PVD: Peripheral Vascular Disease; CV: Cardiovascular