Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis
Objectives We sought to establish the minimum level of clinical benefit attributable to the Victorian Cardiac Outcomes Registry (VCOR) for the registry to be cost-effective.Design A modelled cost-effectiveness study of VCOR was conducted from the Australian healthcare system and societal perspective...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/4/e066106.full |
| _version_ | 1797839185985404928 |
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| author | Danny Liew Christopher M Reid Dion Stub Ella Zomer Peter Lee Angela L Brennan Jeffrey Lefkovits Diem T Dinh |
| author_facet | Danny Liew Christopher M Reid Dion Stub Ella Zomer Peter Lee Angela L Brennan Jeffrey Lefkovits Diem T Dinh |
| author_sort | Danny Liew |
| collection | DOAJ |
| description | Objectives We sought to establish the minimum level of clinical benefit attributable to the Victorian Cardiac Outcomes Registry (VCOR) for the registry to be cost-effective.Design A modelled cost-effectiveness study of VCOR was conducted from the Australian healthcare system and societal perspectives.Setting Observed deaths and costs attributed to coronary heart disease (CHD) over a 5-year period (2014–2018) were compared with deaths and costs arising from a hypothetical situation which assumed that VCOR did not exist. Data from the Australian Bureau of Statistics and published sources were used to construct a decision analytic life table model to simulate the follow-up of Victorians aged ≥25 years for 5 years, or until death. The assumed contribution of VCOR to the proportional change in CHD mortality trend observed over the study period was varied to quantify the minimum level of clinical benefits required for the registry to be cost-effective. The marginal costs of VCOR operation and years of life saved (YoLS) were estimated.Primary outcome measures The return on investment (ROI) ratio and the incremental cost-effectiveness ratio (ICER).Results The minimum proportional change in CHD mortality attributed to VCOR required for the registry to be considered cost-effective was 0.125%. Assuming this clinical benefit, a net return of $A4.30 for every dollar invested in VCOR was estimated (ROI ratio over 5 years: 4.3 (95% CI 3.6 to 5.0)). The ICER estimated for VCOR was $A49 616 (95% CI $A42 228 to $A59 608) per YoLS. Sensitivity analyses found that the model was sensitive to the time horizon assumed and the extent of registry contribution to CHD mortality trends.Conclusions VCOR is likely cost-effective and represents a sound investment for the Victorian healthcare system. Our evaluation highlights the value of clinical quality registries in Australia. |
| first_indexed | 2024-04-09T15:54:00Z |
| format | Article |
| id | doaj.art-6476a0a21acc4815844baaf2f2c9f454 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-09T15:54:00Z |
| publishDate | 2023-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-6476a0a21acc4815844baaf2f2c9f4542023-04-26T00:00:07ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113410.1136/bmjopen-2022-066106Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysisDanny Liew0Christopher M Reid1Dion Stub2Ella Zomer3Peter Lee4Angela L Brennan5Jeffrey Lefkovits6Diem T Dinh71 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia1 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia1 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaDepartment of Cardiology, Melbourne Health, Parkville, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaObjectives We sought to establish the minimum level of clinical benefit attributable to the Victorian Cardiac Outcomes Registry (VCOR) for the registry to be cost-effective.Design A modelled cost-effectiveness study of VCOR was conducted from the Australian healthcare system and societal perspectives.Setting Observed deaths and costs attributed to coronary heart disease (CHD) over a 5-year period (2014–2018) were compared with deaths and costs arising from a hypothetical situation which assumed that VCOR did not exist. Data from the Australian Bureau of Statistics and published sources were used to construct a decision analytic life table model to simulate the follow-up of Victorians aged ≥25 years for 5 years, or until death. The assumed contribution of VCOR to the proportional change in CHD mortality trend observed over the study period was varied to quantify the minimum level of clinical benefits required for the registry to be cost-effective. The marginal costs of VCOR operation and years of life saved (YoLS) were estimated.Primary outcome measures The return on investment (ROI) ratio and the incremental cost-effectiveness ratio (ICER).Results The minimum proportional change in CHD mortality attributed to VCOR required for the registry to be considered cost-effective was 0.125%. Assuming this clinical benefit, a net return of $A4.30 for every dollar invested in VCOR was estimated (ROI ratio over 5 years: 4.3 (95% CI 3.6 to 5.0)). The ICER estimated for VCOR was $A49 616 (95% CI $A42 228 to $A59 608) per YoLS. Sensitivity analyses found that the model was sensitive to the time horizon assumed and the extent of registry contribution to CHD mortality trends.Conclusions VCOR is likely cost-effective and represents a sound investment for the Victorian healthcare system. Our evaluation highlights the value of clinical quality registries in Australia.https://bmjopen.bmj.com/content/13/4/e066106.full |
| spellingShingle | Danny Liew Christopher M Reid Dion Stub Ella Zomer Peter Lee Angela L Brennan Jeffrey Lefkovits Diem T Dinh Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis BMJ Open |
| title | Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis |
| title_full | Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis |
| title_fullStr | Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis |
| title_full_unstemmed | Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis |
| title_short | Estimating the cost-effectiveness and return on investment of the Victorian Cardiac Outcomes Registry in Australia: a minimum threshold analysis |
| title_sort | estimating the cost effectiveness and return on investment of the victorian cardiac outcomes registry in australia a minimum threshold analysis |
| url | https://bmjopen.bmj.com/content/13/4/e066106.full |
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