Abstract
Background
Familial hypercholesterolemia (FH) is a common inherited cause for premature coronary artery disease (CAD) that increases suffering and disability in affected people. However, the extent to which FH impacts work productivity at a population level is unclear.
Objective
We aimed to quantify the burden of heterozygous FH (HeFH) in terms of productivity-adjusted life years (PALYs) lost to HeFH in Australia.
Methods
A life table model was constructed to quantify years of life and PALYs lived by Australians with HeFH (prevalence 1 in 300) and of working age (aged 20 to 69 years). Follow-up was simulated until age 70 years. The model was then resimulated, but assuming the cohort did not have HeFH. Increased cardiovascular mortality and reduction in productivity attributable to HeFH were sourced from published data. Differences in total years of life, QALYs and PALYs lived by the ‘HeFH cohort’ and the same cohort without HeFH (‘non-HeFH cohort’) reflected the QALYs and PALYs lost due to HeFH. All future costs and outcomes were discounted by 5% annually.
Results
In 2017, an estimated 51,587 people of working age in Australia (0.33%) had HeFH. Over their working lifetime, we predicted that 2,950 excess cardiovascular deaths occurred in the current Australian population of working age individuals with HeFH, resulting in a loss of 24,728 years of life. In terms of productivity, HeFH led to the loss of 24,955 PALYs over the working lifetime. Based on gross domestic product (GDP) per equivalent full-time worker, this equated to a total of AUD 5.23 billion in lost GDP over the working lifetime, with an average of AUD 101,366 lost per person. A relative reduction of 20% in cardiovascular deaths (as can be achieved with adequate cholesterol control) would lead to 1,113 PALYs and AUD 233 million in GDP saved in the HeFH cohort.
Conclusion
The impact of HeFH on work productivity is significant. Screening and prevention strategies tailored early in life are likely to exert not only a positive impact on health, but also the economy.
Familial hypercholesterolemia (FH) is a common inherited cause for premature coronary artery disease (CAD) that increases suffering and disability in affected people. However, the extent to which FH impacts work productivity at a population level is unclear.
Objective
We aimed to quantify the burden of heterozygous FH (HeFH) in terms of productivity-adjusted life years (PALYs) lost to HeFH in Australia.
Methods
A life table model was constructed to quantify years of life and PALYs lived by Australians with HeFH (prevalence 1 in 300) and of working age (aged 20 to 69 years). Follow-up was simulated until age 70 years. The model was then resimulated, but assuming the cohort did not have HeFH. Increased cardiovascular mortality and reduction in productivity attributable to HeFH were sourced from published data. Differences in total years of life, QALYs and PALYs lived by the ‘HeFH cohort’ and the same cohort without HeFH (‘non-HeFH cohort’) reflected the QALYs and PALYs lost due to HeFH. All future costs and outcomes were discounted by 5% annually.
Results
In 2017, an estimated 51,587 people of working age in Australia (0.33%) had HeFH. Over their working lifetime, we predicted that 2,950 excess cardiovascular deaths occurred in the current Australian population of working age individuals with HeFH, resulting in a loss of 24,728 years of life. In terms of productivity, HeFH led to the loss of 24,955 PALYs over the working lifetime. Based on gross domestic product (GDP) per equivalent full-time worker, this equated to a total of AUD 5.23 billion in lost GDP over the working lifetime, with an average of AUD 101,366 lost per person. A relative reduction of 20% in cardiovascular deaths (as can be achieved with adequate cholesterol control) would lead to 1,113 PALYs and AUD 233 million in GDP saved in the HeFH cohort.
Conclusion
The impact of HeFH on work productivity is significant. Screening and prevention strategies tailored early in life are likely to exert not only a positive impact on health, but also the economy.
| Original language | English |
|---|---|
| Pages (from-to) | 799-806.e3 |
| Journal | Journal of Clinical Lipidology |
| Volume | 14 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1 Nov 2020 |