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NHS could save £68bn if all high-risk CVD patients were found and treated



The NHS could save £68bn if all patients at high risk of cardiovascular disease in England were identified and treated at current levels of care, researchers have calculated. 

An economic analysis looking at current levels of disease detection and treatment in adults for six high-risk conditions against a scenario of 100% found 3.4mcardiovascular events could be prevented over a 25-year period.

Researchers at the School of Health & Related Research at the University of Sheffield calculated that finding and managing all patients with high blood pressure, high cholesterol, atrial fibrillation, diabetes (types 1 and 2), high blood glucose and chronic kidney disease would lead to 4.9m quality-adjusted life years gained compared with current care and would be cost saving within a decade.

Writing in BMJ Open, they added that if all high risk adults were identified and managed according to NICE guidance, ‘the health benefits increase considerably at all time points’ with an estimated 5.2m cardiovascular events by 25 years saving the NHS £61bn.

The interventions would not be cost saving under this scenario until year 13 because of the substantially higher costs of managing patients, they said.

While a scenario of 100% is clearly not realistic, they pointed out, this is the first time the potential benefits of diagnosing and treating the six conditions previously highlighted by NHS England as being under-diagnosed and treated.

‘This analysis has shown that improving detection and management of the six CVD high-risk groups identified through the NHS RightCare pathway is likely to result in significant health benefits and cost savings,’ they concluded.

In 2015, it was estimated that cardiovascular disease cost the UK economy around £23.3bn overall.  

The greatest long term saving in the modelling was seen in identifying undiagnosed cases of diabetes, while in the short-term picking up high cholesterol had the most impact.

Benefits to the NHS from maximising detection of atrial fibrillation and chronic kidney disease were relatively small despite them carrying a very high risk cardiovascular risk because of the low prevalence in the population, the researchers explained.

The model also showed little difference between managing all patients with diabetes to current standards or according to NICE guidelines because of good adherence to national recommendations through QOF and the National Diabetes Audit, they pointed out.

‘While this analysis can be used to estimate how much money could potentially be spent on interventions to improve detection and management in high-risk individuals, further research is needed to determine what policy changes would be required in practice,’ they concluded.