728 Estimating the Health Loss Due to Poor Engagement with Cardiac Rehabilitation in Australia

Abstract

Cardiac rehabilitation (CR) programs are effective in reducing cardiovascular mortality and readmissions. The lifetime economic costs and life years gained from CR in Australia are unknown, with no research confirming the cost-effectiveness of its current provision. To quantify the scale of health loss due to poor engagement with CR programs, and to estimate how much funding can be justifiably reallocated to improve uptake of CR programs. Economic modelling was undertaken to estimate the expected lifetime health impact and costs. Population health gains and costs, associated with uptake rates of 60%, and 85%, were calculated. A probabilistic sensitivity analysis was conducted to explore uncertainty in the evidence used to populate the model. CR was considered cost-effective with a mean ICER of $6096/QALY and 98.7% probability of being cost-effective at a cost-effectiveness threshold of $50 000. Importantly, an average of 0.52 years of life expectancy are lost due to national uptake being below 60%. The analysis indicates that $12.9 million/year could be justifiably reallocated from public funds to achieve a national uptake rate of 60%, while maintaining cost-effectiveness of CR. If the uptake rate is increased to 85%, there would be a reduction of 1,493 hospital admissions and 972 deaths avoided. The justifiable cost to reach this target is of $23,416,812/year. CR is a cost-effective service for patients with coronary heart disease. Additional investment in CR should be a national priority as the health gains for patients far outweigh the costs.