Inside CKD: projecting the economic burden of chronic kidney disease using patient-level microsimulation modelling

As part of the ongoing collaboration between HealthLumen and AstraZeneca to quantify the health and economic burden of Chronic Kidney Disease (CKD), this poster, presented at ISPOR 2021, demonstrates that the burden of CKD is projected to increase by 2026 for all 11 countries included in this analysis. This highlights the need for national policies aimed at early intervention to slow disease progression and reduce healthcare costs.

View case study

Modelling the potential impact of a reduction in salt consumption on hypertension, coronary heart disease and stroke in the population of the United Kingdom from 2021 to 2035

Poor diet contributes to the high prevalence of hypertension, obesity and non-communicable diseases (NCDs), such as cardiovascular diseases, cancers and diabetes, in Europe. In particular, high levels of salt consumption are harmful to the cardiovascular system. Therefore, a comprehensive strategy to improve diet, including reducing the levels of salt consumption is widely recognised as a strategy to improve health at a population level.

For this study, the British Heart Foundation commissioned HealthLumen to develop a microsimulation model to quantify the significant health and economic benefits that could be achieved by 2035 if UK adult salt consumption was reduced to 6g per day, as per current recommendations, by 2024 and 5g per day by 2030, in line with the WHO target.

Results show that a reduction in salt consumption could attenuate the health and economic burden of hypertension, CHD and stroke. Under the intervention (salt reduction) scenario, we project that 1.4 million fewer people will be living with hypertension in 2035 compared to the baseline scenario. We project that 134,789 cumulative incidences of CHD and 48,540 cumulative incidences of stroke could be avoided by 2035. We project that these reductions will incur direct cost savings of £6.70 billion and indirect cost savings of £4.70 billion between 2021 and 2035.

Given the health and economic benefits that would be generated by a reduction in daily salt consumption, UK Government action that seeks to enforce the national salt reduction policy outlined in this report would contribute significantly to the 2019 NHS target of preventing “up to 150,000 heart attacks, strokes and dementia cases over the next 10 years.”

View blog post

View case study

Quantifying the epidemiological burden of anemia of CKD in the USA and Canada via microsimulation modelling

Chronic kidney disease (CKD) is a debilitating condition that affects approximately 10% of the global population. Anemia is common in patients with CKD, occurring in approximately 15% of patients, and is associated with a high risk of complications and reduced quality of life.

The number of patients in the USA and Canada who will be affected by anemia of CKD over the next 5 years and who will require treatment has not been reliably estimated. This study, commissioned by AstraZeneca, projects the epidemiological burden of anemia of CKD in the USA and Canada using a patient-level, microsimulation-model.

In the USA the prevalence of stage 3a–5 CKD with anemia is projected to increase from 5.4 million cases in 2021 to 6.9 million cases in 2026. In Canada, the prevalence of anemia of stage 3a–5 CKD is projected to increase from approximately 1.5 million patients in 2021 to 2.2 million patients in 2026.

The projected increasing prevalence of advanced CKD and associated anemia, as well as the estimated increases in numbers of related cardiovascular (CV) events and patients who will require treatment, could put healthcare systems under greater pressure, and demonstrates a need for healthcare policy in the USA and Canada to prepare to support this patient population.

View case study

Health impacts of air pollution: Modelling the health impact of air pollution in Lambeth and Southwark

Air pollution has an adverse effect on people’s health, both in the long- and short-term. The Guy’s and St Thomas’ Charity commissioned HealthLumen to undertake a project to quantify the impact of air pollution on the health of the populations of the London boroughs of Lambeth and Southwark. In these areas, the majority of air pollution comes from road traffic, but also from heating and construction emissions. A number of policies have been put in place London-wide to reduce air pollution emissions and therefore prevent related impacts (for example ULEZ and BreatheLondon), as well as locally in Lambeth and Southwark. The findings of this study build on the existing body of knowledge on this topic by quantifying the impact of specific scenarios on air-pollution related health burden.

The key conclusions are that borough-specific and pan-London actions are required alongside local and national legislation and policy if larger health benefits and cost savings are to be made. It is clear that measures to maintain levels of NO2 emissions found during the COVID-19 lockdown and to meet the WHO levels for PM2.5 would have significant health and cost benefits for both Lambeth and Southwark.

View blog post

View case study

Making Conversations Count for All: Benefits of improving delivery of smoking cessation interventions for different socioeconomic groups.

This study builds on the previous 2020 report by looking at the impact of improving the delivery of three advice-based interventions on different socioeconomic groups, compared with current policy, between 2019-2039. By focusing on socioeconomic status, this study explores one component of deprivation to assess the impact of improving the delivery of these interventions on smoking related health inequalities and associated economic costs in the UK.

View case study

The burden of liver diseases, stroke, and coronary heart disease in France, to 2030

Obesity is increasing across Europe, and together with alcohol consumption, is contributing to rising rates of chronic liver diseases. Quantifying the epidemiological and economic burden of obesity and alcohol-related conditions will provide evidence for appropriate interventions and policies to be implemented. This study develops an existing microsimulation model to account for body mass index(BMI) and alcohol as interacting joint risk factors to quantify the burden of liver diseases, stroke, and coronary heart disease(CHD), in France, from 2020 to 2030. The impact of hypothetical scenarios are quantified.

View overview video

View case study

Tipping the scales: Why preventing obesity makes economic sense

Together with Cancer Research UK, we produced a report which looked at the health and economic impact of ever-increasing overweight and obesity rates in the UK. We showed that even a small reduction in obesity prevalence could offset the significant health and economic cost of doing nothing.

View case study

Estimating the future burden of chronic kidney disease through microsimulation methods

Chronic kidney disease (CKD) is a debilitating and costly condition, affecting over 10% of the global population and linked with increased risk of cardiovascular disease (CVD) and all-cause mortality. People in the early stages of CKD are often asymptomatic; as many as 44% may remain undiagnosed until CKD has progressed to a more advanced stage. Early diagnosis of the at-risk population may be possible through implementing routine screening policies. Early diagnosis and proactive medical management are known to mitigate the rates of progression of CKD to end-stage renal disease and may improve clinical outcomes. The aims of this study were 1) to estimate the epidemiological and cost burden of CKD in the UK from 2020 to 2025 assuming no change to current practice and 2) to estimate the impact of routine screening and subsequent early intervention on future disease burden and healthcare costs. Undertaken in partnership with AstraZeneca, this study is now being rolled out to over 20 countries.

View case study

Why we must work toward a recognised international standard in evaluation of upstream interventions

The COVID-19 pandemic has increased interest in Universal Basic Income (UBI) as a means of addressing a range of socio-economic insecurities. While previous trials of cash transfer schemes have often focused on low-level transfers inadequate to satisfy the needs for which the policy was originally developed, emerging pilots are moving toward a position of increasing generosity. Our multidisciplinary project, Examining the Health Case for UBI, has brought together colleagues in behavioural science, public health, epidemiology and economics to establish pathways to health impact.

View case study

Making Conversations Count: The health and economic benefits of improving smoking cessation support

This study conducted with Cancer Research UK aimed to quantify the health and economic benefits of GPs routinely delivering stop smoking support to patients during consultations in the UK. Using a microsimulation model over the period 2019 to 2039, a current practice 'baseline' scenario was compared to three opt-out smoking cessation intervention scenarios.

View case study