Non-communicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are the leading causes of death worldwide. 

A recent report by FP Analytics sets out the scale of the problem and the health and economic burden of NCDs.  These conditions share a common set of risk factors of which the main ones are tobacco use, physical inactivity, alcohol consumption, and an unhealthy diet. Given the significant burden of NCDs, there is an urgent need for effective strategies to prevent their occurrence and progression. The report highlights how the NCD epidemic could be significantly mitigated with interventions for both earlier detection and earlier treatment’.

These interventions aim to identify individuals who are at high risk for NCDs before they contract the disease, while also providing targeted interventions including new drugs to slow progression of a disease once contracted, digital therapies to help manage a chronic condition, and public health interventions that aim to reduce the key causes of NCDs by targeting the key risk factors.

A key question the report poses is “What Strategies for Early Action Against NCDs are Cost-Effective and Impactful Investments?” This is where microsimulation modelling can play a key role, by simulating the health and economic outcomes of a population over time, taking into account individual risk factors such as age, sex, lifestyle, and health status. Such modelling can be used to quantify the impact that different intervention programmes, such as changes in behaviours, or new therapeutics, have on future disease morbidity, mortality, and costs. 

This then provides evidence to inform decisions and support the case for change, for example, decisions made by payers about which technologies and/or services to fund, or by pharmaceutical companies developing new therapies, or public health bodies considering policy interventions such as earlier screening.

A recent example of this is our work with AstraZeneca on Chronic Kidney Disease, a condition which is often undiagnosed and for which there is substantial variation in the effectiveness of screening and subsequent management. 

  • AstraZeneca’s “Inside CKD” programme is designed to analyse the projected prevalence and burden of CKD for some 31 countries across the world, and to simulate hypothetical intervention strategies that can then be assessed for potential impact on health and economic outcomes at a national and a global level.

A recent paper, published in Advances in Therapy reviews the Inside CKD programme, and highlights why  microsimulation is considered the most appropriate approach for modelling NCDs and proposed interventions. As noted in the paper:

  • “Microsimulation analyses can complement clinical studies by conducting population-level analyses and projecting expected outcomes. A particular strength is that they allow for continuous, dynamic risk factors that can be modified over time, compared with the static risk factors employed in more traditional, macroscopic models”

Another key benefit of microsimulation modelling is the ability to identify populations that are most in need of early intervention. By taking into account individual risk factors, modelling can identify subgroups of the population that are at highest risk for NCDs, and prioritise interventions for these individuals. This can help to ensure that early intervention programmes are targeted to those who are most likely to benefit, and can also help to optimise the use of limited resources. As the paper notes:

  • Patient-level approaches allow for recurring events across various health states, which can then be quantified by following a population of hypothetical individuals over time through a structured, robust model. This approach is valuable for policymakers who wish to consider how a specific demographic is affected by a condition, or how a disease is distributed differently on the basis of underlying characteristics.”

In conclusion, microsimulation modelling can provide a comprehensive and long-term view of the impact of different intervention strategies, playing a key role in informing decision-making, and in helping to prevent the devastating impact of NCDs.

We are looking forward to exploring these issues with friends and colleagues at the upcoming Evidence, Pricing and Access World Congress, at which HealthLumen will be discussing the above themes in a presentation at 12:25 on Day 3.

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