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通过改善澳大利亚2型糖尿病患者的危险因素控制来减轻心血管疾病的生产力负担:一项为期10年的动态分析。

The Reduction of the Productivity Burden of Cardiovascular Disease by Improving the Risk Factor Control Among Australians with Type 2 Diabetes: A 10-Year Dynamic Analysis.

作者信息

Abushanab Dina, Al-Badriyeh Daoud, Marquina Clara, Morton Jedidiah I, Lloyd Melanie, Zomer Ella, Talic Stella, Liew Danny, Ademi Zanfina

机构信息

Health Economics and Policy Evaluation Research (HEPER), Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.

College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

出版信息

Eur J Prev Cardiol. 2024 Sep 6. doi: 10.1093/eurjpc/zwae292.

Abstract

AIMS

To quantify the productivity burden of cardiovascular disease (CVD) in type 2 diabetes and the potential benefits of improved CVD risk factor control.

METHODS

We designed models to quantify the productivity burden (using the productivity-adjusted life-year; PALY) of CVD in Australians with type 2 diabetes aged 40-69 years from 2023-2032. PALYs were ascribed a financial value equivalent to gross domestic product (GDP) per full-time worker (AU$204,167 (€124,542)). The base-case model was designed to quantify the productivity burden of CVD in the target population. Then, other hypothetical scenarios were simulated to estimate the potential productivity gains resulting from improved control of risk factors. These scenarios included reductions in systolic blood pressure (SBP), number of smokers, total cholesterol, and incidence of type 2 diabetes. All future costs and outcomes were discounted at an annual rate of 5%.

RESULTS

In the base-case (i.e. current projections), the estimated total PALYs lost due to CVD in type 2 diabetes were 1.21 million (95%CI (1.10-1.29 million), contributing to an AU$258.93 (€157.94) billion (95%CI (AU$258.73-261.69 (€157.83-159.63) billion) lost in the country's GDP. If there were reductions in SBP, number of smokers, total cholesterol, and incidence of type 2 diabetes, there would be gains of 7,889, 28,971, 7,117, and 320,124 PALYs, respectively. These improvements would also lead to economic gains of AU$1.72 (€1.05) billion, AU$6.21 (€3.79) billion, AU$1.55 billion (€947.33 million), and AU$68.34 (€41.69) billion, respectively.

CONCLUSIONS

Targeted "early lifestyle" strategies that can prevent CVD in Australians with type 2 diabetes are likely positively impact Australian health and work productivity.

摘要

目的

量化2型糖尿病中心血管疾病(CVD)的生产力负担以及改善CVD危险因素控制的潜在益处。

方法

我们设计了模型,以量化2023年至2032年40至69岁澳大利亚2型糖尿病患者中CVD的生产力负担(使用生产力调整生命年;PALY)。PALY被赋予相当于每位全职工人的国内生产总值(GDP)的财务价值(204,167澳元(124,542欧元))。基础模型旨在量化目标人群中CVD的生产力负担。然后,模拟其他假设情景,以估计改善危险因素控制所带来的潜在生产力收益。这些情景包括收缩压(SBP)降低、吸烟者数量减少、总胆固醇降低以及2型糖尿病发病率降低。所有未来成本和结果均按5%的年利率进行贴现。

结果

在基础情景(即当前预测)中,2型糖尿病中因CVD损失的估计总PALY为121万(95%CI(110 - 129万)),导致该国GDP损失2589.3亿澳元(1579.4亿欧元)(95%CI(2587.3 - 2616.9亿澳元(1578.3 - 1596.3亿欧元))。如果SBP、吸烟者数量、总胆固醇和2型糖尿病发病率降低,分别将获得7889、28971、7117和320124个PALY。这些改善还将分别带来17.2亿澳元(10.5亿欧元)、62.1亿澳元(37.9亿欧元)、15.5亿澳元(9.4733亿欧元)和683.4亿澳元(41.69亿欧元)的经济收益。

结论

有针对性的“早期生活方式”策略可预防澳大利亚2型糖尿病患者的CVD,这可能对澳大利亚的健康和工作生产力产生积极影响。

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