Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care


Turner , D.A., Paul, S., Stone , M.A., Juarez-Garcia, A., Squire, I. and Khunti, K. (2008) Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care. Heart, 92, (12), 1601-1606. (doi:10.1136/hrt.2007.125708).

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Description/Abstract

Objective: To determine if a disease management
programme for patients with coronary heart disease and
heart failure represents an efficient use of health services
resources.

Methods: We carried out an economic evaluation
alongside a cluster randomised control trial of 1163
patients with coronary heart disease and chronic heart
failure in 20 primary care practices in the United Kingdom.
Practices were randomised to either a control group,
where patients received standard general practice care,
or an intervention group where patients had access to a
specialist nurse-led disease management programme. We
estimated costs in both groups for coronary heart
disease-related resource use. The main outcome measure
used in the economic evaluation was quality adjusted life
years (QALY) measured using the EuroQol.

Results: The disease management programme was
associated with an increase in the QALY measured of
0.03 per year and an increase in the total NHS costs of
£425 (J540), of this only £83 was directly associated
with the provision of the nurse clinics. The clinics
generated additional QALY at an incremental cost of
£13 158 per QALY compared to the control group.
Conclusions: The use of a nurse-led disease management
programme is associated with increased costs in
other coronary heart disease-related services as well as
for the costs of the clinics. They are also associated with
improvements in health. Even in the short term these
disease management programmes may represent a costeffective
service, as additional QALY are generated at an
acceptable extra cost.

Item Type: Article
ISSNs: 1355-6037 (print)
1468201 (electronic)
Related URLs:
Subjects: R Medicine > R Medicine (General)
Divisions: University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
ePrint ID: 175675
Date Deposited: 25 Feb 2011 11:34
Last Modified: 27 Mar 2014 19:21
URI: http://eprints.soton.ac.uk/id/eprint/175675

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