Asaria, Miqdad orcid.org/0000-0002-3538-4417, Walker, Simon Mark orcid.org/0000-0002-5750-3691, Palmer, Stephen John orcid.org/0000-0002-7268-2560 et al. (8 more authors) (2016) Using electronic health records to predict costs and outcomes in stable coronary artery disease. Heart. ISSN 1468-201X
Abstract
OBJECTIVES: To use electronic health records (EHR) to predict lifetime costs and health outcomes of patients with stable coronary artery disease (stable-CAD) stratified by their risk of future cardiovascular events, and to evaluate the cost-effectiveness of treatments targeted at these populations. METHODS: The analysis was based on 94 966 patients with stable-CAD in England between 2001 and 2010, identified in four prospectively collected, linked EHR sources. Markov modelling was used to estimate lifetime costs and quality-adjusted life years (QALYs) stratified by baseline cardiovascular risk. RESULTS: For the lowest risk tenth of patients with stable-CAD, predicted discounted remaining lifetime healthcare costs and QALYs were £62 210 (95% CI £33 724 to £90 043) and 12.0 (95% CI 11.5 to 12.5) years, respectively. For the highest risk tenth of the population, the equivalent costs and QALYs were £35 549 (95% CI £31 679 to £39 615) and 2.9 (95% CI 2.6 to 3.1) years, respectively. A new treatment with a hazard reduction of 20% for myocardial infarction, stroke and cardiovascular disease death and no side-effects would be cost-effective if priced below £72 per year for the lowest risk patients and £646 per year for the highest risk patients. CONCLUSIONS: Existing EHRs may be used to estimate lifetime healthcare costs and outcomes of patients with stable-CAD. The stable-CAD model developed in this study lends itself to informing decisions about commissioning, pricing and reimbursement. At current prices, to be cost-effective some established as well as future stable-CAD treatments may require stratification by patient risk.
Metadata
Item Type: | Article | ||||
---|---|---|---|---|---|
Authors/Creators: |
|
||||
Copyright, Publisher and Additional Information: | This content is made available by the publisher under a Creative Commons Attribution Licence. This means that a user may copy, distribute and display the resource providing that they give credit. Users must adhere to the terms of the licence. | ||||
Dates: |
|
||||
Institution: | The University of York | ||||
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) | ||||
Funding Information: |
|
||||
Depositing User: | Pure (York) | ||||
Date Deposited: | 18 Feb 2016 10:26 | ||||
Last Modified: | 07 Mar 2024 00:08 | ||||
Published Version: | https://doi.org/10.1136/heartjnl-2015-308850 | ||||
Status: | Published | ||||
Refereed: | Yes | ||||
Identification Number: | https://doi.org/10.1136/heartjnl-2015-308850 |
Download
Filename: Heart_2016_Asaria_heartjnl_2015_308850.pdf
Description: Heart-2016-Asaria-heartjnl-2015-308850