Simulating a Policy Relevant Reform Option with HealthAgeingMod

In this chapter the policy relevant scenario simulated with HealthAgeingMod concerns the health benefits and costs of an integrated diabetes and cardiovascular disease screening, prevention and management intervention among 40-74 year old Australians. The Scenario was proposed by a group of Australian health policy developers at a time of studies reporting that a significant proportion of Australians were missing out on prevention and recommended treatment. The Scenario reflects Australian practices, costs and medical guidelines.

The screening tests for CVD, diabetes and their risk factors, and high-risk status or diagnosis, is followed by several possible medically identified treatment and prevention paths. Within HealthAgeingMod both single and combined diseases are identified, and account is taken of the non-linear nature of comorbidities.

This policy relevant application compares, over the 2005-2010 period, the outcomes of the scenario simulation with that of the Baseline simulation in terms of extra life years lived and health costs saved. We found that implementing the scenario would result in a net cost to government of around AUD 7,000 per Quality Adjusted Life Years gained. Sensitivity tests indicated a range from AUD 3,000 to AUD 14,000.

Because this range is within what is usually considered to be cost-effective in Australia, an intervention of this kind is worth consideration for public funding.

Keywords: Vascular risk assessment, health modeling, economic analysis, policy relevant simulation, screening, risk scores, medical advice or treatment, cost effectiveness, sensitivity analyses.