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Expenditure on CVD

Expenditure on CVD. Inequity? Orientation of services: Treatment versus prevention. Cost impacts of CVD. Direct financial costs to the Australian health system Other (indirect) financial costs including Productivity losses Carer costs Deadweight loss from transfers

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Expenditure on CVD

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  1. Expenditure on CVD Inequity? Orientation of services: Treatment versus prevention

  2. Cost impacts of CVD • Direct financialcosts to the Australian health system • Other (indirect) financial costs including • Productivity losses • Carer costs • Deadweight loss from transfers • Other costs – aids, equipment, transport and accommodation etc. • Non-financial costs – Burden of Disease • Value of Statistical Life • Disability, loss of wellbeing and premature death • Measured in Disability Adjusted Life Years (DALYs) • Different costs of CVD are borne by different economic entities

  3. Economic burden of CVD in 2008 • CVD one of the biggest health burdens in Australia Estimated total $162 billion • ↑ of 71.4% compared with cost in 2005 • $13.1 billion in financial costs • $148.9 billion non-financial costs Access Economics Pty Ltd. The growing cost of obesity in 2008: three years on. August 2008

  4. Expenditure: Orientation of services

  5. Health care expenditure • Government funded almost 70% of health expenditure in 2007-08 • Recurrent expenditures on health in 2007-08 included: • Hospital services (39.3%) • Medical services (18.7%) • Benefit-paid pharmaceuticals (14%) – excluding those dispensed in hospitals AIHW. Australia's health 2010. 2010

  6. CVD accounted for the greatest amount of government expenditure (11%) in 2004-051 AIHW. Australia's health 2010. 2010.

  7. Expenditure: Treatment vs prevention • 2.2% of governments’ total recurrent expenditure was spent on public health in 2007-08 • ↑ of 2.0% since 2006-07 • largely due to ↑ spending on immunisation programs AIHW. Australia's health 2010. 2010.

  8. Public health expenditure 2007-08 AIHW. Australia's health 2010. 2010.

  9. Indigenous groups • A study by Vos et al. (2007) found ATSIP suffer an overall burden of disease 2.5x that of the total Australian population • 2/3 of health gap was due to mortality and 1/3 due to disability • 70% health gap due to chronic diseases including CVD • AIHW: The Health and Welfare of Australia’s Aboriginal & Torres Strait Islander Peoples. 2005 AIHW. Australia's health 2010. 2010

  10. AIHW. Australia's health 2010. 2010

  11. ACE-Prevention - Assessing Cost-Effectiveness in Prevention (Sept 2010)http://www.sph.uq.edu.au/bodce-ace-prevention • National Health and Medical Research Council funding • Supported by the Cooperative Research Centre for Aboriginal Health. • ACE Prevention Report • Recommendations to support more spending on prevention • Analysis of the value of many health advancement strategies to address the burden of preventable death and disease in Australia.  • Efficient + fairer system of health

  12. Main findings: Large impact on population health (i.e. >100,000 DALYs prevented per intervention): • taxation of tobacco, alcohol and unhealthy foods; • a mandatory limit on salt in just three basic food items (bread, cereals and margarine); • using an absolute risk approach • using cost-effective generic drugs (low-cost polypill = 3 BP-lowering + 1 cholesterol-lowering) • gastric banding for severe obesity

  13. Main findings: Moderate impact on population health (10,000 to 100,000 DALYs prevented per intervention): • screening programs for pre-diabetes, CKD and low bone mineral density in elderly women. • drug and lifestyle treatments recommended for the high-risk individuals identified by such screening programs. • smoking cessation aids, pedometers and mass media for physical activity

  14. Dominant interventions • The package of 20 ‘dominant’ interventions could avert one million DALYs over the lifetime of the 2003 Australian population. • 80% of this health gain could be achieved with the taxation and regulation interventions on salt, alcohol and tobacco, and the polypill for CVD prevention. • Cost = $4.6 billion, • Savings = $11 billion in health care costs

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