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The impact of coronary heart disease prevention on work productivity: a 10-year analysis.

AIMS
To determine the impact of preventing new (incident) cases of coronary heart disease (CHD) on years of life and productivity, using the novel measure 'productivity-adjusted life year' (PALY), over the next 10 years.


METHODS AND RESULTS
A dynamic life table model was constructed for the total Australian working-age population (15-69 years) over 10 years (2020-2029), separated by CHD status. Productivity estimates were sourced from the literature. The PALY was ascribed a financial value in terms of gross domestic product (GDP) per equivalent full-time worker. The total number of years lived, PALYs, and economic burden (in terms of GDP per PALY) were estimated. The model simulation was repeated assuming incidence was reduced, and the differences represented the impact of CHD prevention. All outcomes were discounted by 5% per annum. Over 10 years, the total projected years lived and PALYs in the Australian working-age population (with and without CHD) were 132 million and 83 million, respectively, amounting to A$17.2 trillion in GDP. We predicted nearly 40 000 new (incident) CHD cases over the next 10 years. If all new cases of CHD could be prevented during this period, a total of 14 000 deaths could be averted, resulting in more than 8000 years of life saved and 104 000 PALYs gained, equivalent to a gain of over A$21.8 billion (US$14.8 billion) in GDP.


CONCLUSION
Prevention of CHD will prolong years of life lived and productive life years, resulting in substantial economic benefit. Policy makers and employers are encouraged to engage in preventive measures addressing CHD.