Prediction models for individual-level healthcare costs associated with cardiovascular events in the UK

Objectives: To develop prediction models for the individual-level impacts of cardiovascular events on UK healthcare costs. Methods: In the UK Biobank, people 40-70 years old, recruited in 2006-2010, were followed in linked primary (N=192 983 individuals) and hospital care (N=501 807 individuals) datasets. Primary and hospital care costs’ (2020 UK£) regression models of annual costs associated with individual characteristics and experiences of myocardial infarction (MI), stroke, coronary revascularization, incident diabetes and cancer, and vascular and nonvascular death are reported. Results: For both people without and with previous CVD, primary care costs were modelled using onepart generalised linear models (GLMs) with identity link and Poisson distribution, and hospital costs with two-part models (part 1: logistic regression models probability of incurring costs; part 2: GLM with identity link and Poisson distribution models costs conditional on incurring any). In people without previous CVD, mean annual primary and hospital care costs were £360 and £514. The excess primary care costs were £190 and £360 following MI and stroke, respectively, whereas excess hospital costs decreased from £4340 and £5590, respectively, in the year of these events, to £190 and £410 two years after. People with previous CVD had more than twice higher annual costs, and incurred higher excess costs for cardiovascular events. Other characteristics associated with higher costs included older age, female sex, south Asian ethnicity, higher socioeconomic deprivation, smoking, lower level of physical activities, unhealthy body mass index, and comorbidities. Conclusions: These individual-level healthcare cost prediction models could inform assessments of the value of health technologies and policies to reduce cardiovascular and other disease risks and healthcare costs. An accompanying Excel calculator is available to facilitate the use of the models.