The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada

January The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada David Boisclair 0 1 Yann De carie 1 FrancË ois Laliberte -Auger 0 1 Pierre-Carl Michaud 0 1 Carole Vincent 1 0 HEC Montr eÂal , MontreÂal, QueÂbec , Canada , 2 Institut national de la recherche scientifique (INRS) - Urbanisation, culture et socieÂte , MontreÂal, QueÂbec , Canada , 3 Consultant in Social and Economic Studies , Montr eÂal, Qu eÂbec , Canada 1 Editor: Brecht Devleesschauwer, Scientific Institute of Public Health (WIV-ISP) , BELGIUM We assess how different scenarios of cardiovascular disease (CVD) prevention, aimed at meeting targets set by the World Health Organization (WHO) for 2025), may impact healthcare spending in Quebec, Canada over the 2050 horizon. We provide long-term forecasts of healthcare use and costs at the Quebec population level using a novel dynamic microsimulation model. Using both survey and administrative data, we simulate the evolution of the Quebec population's health status until death, through a series of dynamic transitions that accounts for social and demographic characteristics associated with CVD risk factors. A 25% reduction in CVD mortality between 2012 and 2025 achieved through decreased incidence could contain the pace of healthcare cost growth towards 2050 by nearly 7 percentage points for consultations with a physician, and by almost 9 percentage points for hospitalizations. Over the 2012±2050 period, the present value of cost savings is projected to amount to C$13.1 billion in 2012 dollars. The years of life saved due to improved life expectancy could be worth another C$38.2 billion. Addressing CVD mortality directly instead would bring about higher healthcare costs, but would generate more value in terms of years of life saved, at C$69.6 billion. ☯ These authors contributed equally to this work; * pierre-carl; michaud@hec; ca - Data Availability Statement: Detailed documentation of the model as well as the code and inputs used to generate our results (the documentation is in the documentations directory) is available here: https://github.com/CEDIAmodels/compascvd2017. Three sources of data are used in building and using COMPAS. We cannot share all these data because they belong to third-party government agencies, they contain potentially sensitive information, and the data access procedures and agreements under which we have accessed the data legally preclude us from Objectives Results Conclusions Potential savings associated with plausible reductions in CVD, aimed at reaching a World Health Organization target over a 12-year period, are sizeable and may help address challenges associated with an aging population. sharing the said data, as explained below. Confidential Microdata Files from Statistics Canada's National Population Health Survey (NPHS) and General Social Survey are accessible to researchers using the procedure described on the website of the Canadian Research Data Centre Network: https://crdcn.org/research. Public-Use Microdata Files (PUMFs) from other Statistics Canada surveys (Canadian Community Health Survey and Labour Force Survey) are freely accessible to researchers who belong to an institution that is a Data Liberation Initiative partner. Data access information for DLI members are available here: http://www.statcan.gc.ca/eng/ dli/caselaw/license. Researchers who wish to access Public-Use Microdata Files (PUMFs) outside the Data Liberation Initiative should use `Option 4' at this link: https://www.statcan.gc.ca/ eng/dli/caselaw/decline. Confidential administrative data on physician billing and hospital outlays at the patient level (extracts from the Services meÂdicaux reÂmuneÂreÂs à l'acte and the MEDECHO databases, respectively) were obtained from the ReÂgie de l'assurance maladie du QueÂbec under a data access agreement for research purposes. The procedure to obtain these data is available here: http://www.ramq.gouv.qc.ca/en/data-statistics/ Pages/data-statistics.aspx. Funding: All authors have been paid by universities (Universite du QueÂbec à MontreÂal or HEC MontreÂal) while working on this study. All authors except Michaud were paid with general research funds held by the Industrial Alliance Research Chair on the Economics of Demographic Change (http:// www.cedia.ca), an academic research unit of which Michaud is a co-holder. The Chair itself receives funding from the Center for Interuniversity Research and Analysis of Organizations (CIRANO), Retraite QueÂbec and iA Financial Group. Here are their websites: https://cirano.qc.ca; http://www. retraitequebec.gouv.qc.ca; http://ia.ca/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Introduction As the leading cause of death in adult Canadian men and women, cardiovascular disease (CVD) ranked first in 2008 for (...truncated)