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.

Abstract

To quantify the productivity burden of cardiovascular disease (CVD) in type 2 diabetes and the potential benefits of improved CVD risk factor control. 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%. 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. Targeted "early lifestyle" strategies that can prevent CVD in Australians with type 2 diabetes are likely positively impact Australian health and work productivity. This study aimed to assess the productivity burden of cardiovascular disease (CVD) in individuals with type 2 diabetes and the potential benefits of improving the control of CVD risk factors. We developed models to estimate the productivity burden using a measure called productivity-adjusted life-years (PALY). We assigned a financial value to PALYs based on the country's gross domestic product (GDP) per full-time worker. The base-case model showed that the estimated total PALYs lost due to CVD in type 2 diabetes were 1.21 million (95%CI (1.10-1.29 million), contributing AU$258.93 (€157.94) billion (95%CI (AU$258.73-261.69 (€157.83-159.63) billion) lost in the country's GDP.We also simulated hypothetical scenarios to explore the potential gains from reducing risk factors. We found that reductions in systolic blood pressure (SBP), smoking rates, total cholesterol, and the incidence of type 2 diabetes could lead to gains of 7,889, 28,971, 7,117, and 320,124 PALYs, respectively. These improvements would also result in 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.Targeted strategies focusing on early lifestyle interventions to prevent CVD in individuals with type 2 diabetes can have a positive impact on both health outcomes and work productivity in Australia.