Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/37708
Title: Using electronic health records to predict costs and outcomes in stable coronary artery disease
Authors: Asaria, Miqdad
Walker, Simon
Palmer, Stephen
Gale, Chris P.
Shah, Anoop D.
Abrams, Keith R.
Crowther, Michael
Manca, Andrea
Timmis, Adam
Hemingway, Harry
Sculpher, Mark
First Published: 10-Feb-2016
Publisher: BMJ Publishing Group with British Cardiovascular Society
Citation: Heart, 2016, 102 (10), pp. 755-762
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.
DOI Link: 10.1136/heartjnl-2015-308850
eISSN: 1468-201X
Links: http://heart.bmj.com/content/102/10/755
http://hdl.handle.net/2381/37708
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © The Authors, 2016. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Appears in Collections:Published Articles, Dept. of Health Sciences

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