Health Economics Scenario Lab
FrailtyForward
Explore how earlier frailty support might change crisis events, admissions, bed use, and value under different assumptions about reach, effectiveness, persistence, and delivery cost.
Scope and use note
FrailtyForward is an exploratory scenario sandbox. It is designed to test how changes in frailty risk, support reach, crisis reduction, admission reduction, persistence, and delivery cost might influence pathway and economic value. It does not replace formal evaluation, forecasting, or business case development.
Signal
Above current threshold
Discounted net cost
£575,569
Cost/QALY
£42,490
Headline view
Start with the current decision signal and the main economic outputs.
Patients stabilised
279
Crisis events avoided
98
Discounted net cost
£575,569
Discounted cost per QALY
£42,490
Overall signal
Above current threshold
Current case type
Crisis prevention case
Main driver
The current result is mainly driven by crisis prevention.
Fragility
The case may be fragile because broad implementation can dilute value if the highest-opportunity patients are only a subset of the frailty cohort.
Charts
Primary chart first, with supporting views below.
Patients stabilised
Annual stabilisation across the selected horizon.
Assumptions
Scenario preset first, then quick assumptions and advanced settings.
Preset readout
Base case
Restores the default central case.
Quick assumptions
Share of the cohort effectively reached.
Reduction in crisis or deterioration events.
Relative reduction in admissions.
Reduction in inpatient stay.
Analysis
Review the current case, sensitivity, uncertainty, and practical next checks.
Report export
Export a structured summary of the current assumptions, results, and interpretation.
Decision recommendation
What this suggests
FrailtyForward suggests the support model delivers measurable benefit over 3 years, but the discounted economic case remains above the current threshold.
What is driving it
The current result is mainly driven by crisis prevention.
What looks fragile
The case may be fragile because broad implementation can dilute value if the highest-opportunity patients are only a subset of the frailty cohort.
Validate next
Before using this in a real decision conversation, the most important next checks are: Validate the local cost inputs used in the economic framing. Then check whether the support model would still look worthwhile over around >10 years under locally credible assumptions. Current preset: Base case. Restores the default central case.
Admissions avoided
51
Bed days avoided
553
Return on spend
0.34x
Current case type
Crisis prevention case
Threshold readout
Break-even cost per patient
£227
Required support effect
17.2%
Break-even horizon
>10 years
Uncertainty readout
Low
£93,143
221 patients stabilised · Above current threshold
Base
£42,490
279 patients stabilised · Above current threshold
High
£17,604
338 patients stabilised · Appears cost-effective
Top parameter drivers
Driver 1
Support cost per patient
Largest ICER swing: £25,676
Driver 2
Reduction in crisis event rate
Largest ICER swing: £20,329
Driver 3
QALY gain per patient meaningfully stabilised
Largest ICER swing: £17,704
Sensitivity interpretation
The result is most sensitive to support cost per patient.
Reduction in crisis event rate is the next biggest driver of movement in discounted cost per QALY.
Changes in qaly gain per patient meaningfully stabilised still matter, but less than the leading two drivers.
Comparator snapshot
Comparator
Crisis prevention focus
Current selection versus comparator case.
Patients stabilised delta
112
Admissions avoided delta
-5
Discounted net cost delta
-£13,275
Decision readiness
Validate the local cost inputs used in the economic framing.
Confirm whether a more targeted support strategy would be operationally feasible.
Validate whether admission risk is concentrated among higher-risk or frequent-admitter patients.
Confidence summary
3 high-confidence, 10 medium-confidence, and 7 low-confidence assumptions are currently in play.
Headline view
Start with the current decision signal and the main economic outputs.
Patients stabilised
279
Crisis events avoided
98
Discounted net cost
£575,569
Discounted cost per QALY
£42,490
Admissions avoided
51
Bed days avoided
553
Programme cost
£898,538
Gross savings
£303,030
Overall signal
Above current threshold
Current case type
Crisis prevention case
Main driver
The current result is mainly driven by crisis prevention.
Fragility
The case may be fragile because broad implementation can dilute value if the highest-opportunity patients are only a subset of the frailty cohort.
Return on spend
0.34x
Break-even cost per patient
£227
Required support effect
17.2%
Charts
Primary chart first, with supporting views below.
Patients stabilised
Annual stabilisation across the selected horizon.
Cost vs savings
Cumulative delivery cost compared with gross savings.
Pathway impact
Headline operational impact over the selected horizon.
Bounded uncertainty
Low, base, and high cases against the current threshold.
One-way sensitivity
Largest drivers of movement in discounted cost per QALY.
Assumptions
Scenario preset first, then quick assumptions and advanced settings.
Preset readout
Base case
Restores the default central case.
Quick assumptions
Share of the cohort effectively reached.
Reduction in crisis or deterioration events.
Relative reduction in admissions.
Reduction in inpatient stay.
Advanced assumptions
Analysis
Review the current case, sensitivity, comparator view, and the next checks.
Report export
Export a structured summary of the current assumptions, results, and interpretation.
Admissions avoided
51
Bed days avoided
553
Return on spend
0.34x
Current case type
Crisis prevention case
Decision recommendation
What this suggests
FrailtyForward suggests the support model delivers measurable benefit over 3 years, but the discounted economic case remains above the current threshold.
What is driving it
The current result is mainly driven by crisis prevention.
What looks fragile
The case may be fragile because broad implementation can dilute value if the highest-opportunity patients are only a subset of the frailty cohort.
Validate next
Before using this in a real decision conversation, the most important next checks are: Validate the local cost inputs used in the economic framing. Then check whether the support model would still look worthwhile over around >10 years under locally credible assumptions. Current preset: Base case. Restores the default central case.
Threshold readout
Break-even cost per patient
£227
Required support effect
17.2%
Break-even horizon
>10 years
Uncertainty readout
Low
£93,143
221 patients stabilised · Above current threshold
Base
£42,490
279 patients stabilised · Above current threshold
High
£17,604
338 patients stabilised · Appears cost-effective
Sensitivity
One-way sensitivity
Largest drivers of movement in discounted cost per QALY.
Driver 1
Support cost per patient
Largest ICER swing: £25,676
Driver 2
Reduction in crisis event rate
Largest ICER swing: £20,329
Driver 3
QALY gain per patient meaningfully stabilised
Largest ICER swing: £17,704
Sensitivity interpretation
Takeaway
The result is most sensitive to support cost per patient.
Takeaway
Reduction in crisis event rate is the next biggest driver of movement in discounted cost per QALY.
Takeaway
Changes in qaly gain per patient meaningfully stabilised still matter, but less than the leading two drivers.
Comparator snapshot
Comparator
Crisis prevention focus
Current selection versus comparator case.
Patients stabilised delta
112
Admissions avoided delta
-5
Discounted net cost delta
-£13,275
Decision readout
Uncertainty readout
The case looks fragile: some bounded cases are below threshold, while others are not.
Interpretation summary
FrailtyForward suggests the support model delivers measurable benefit over 3 years, but the discounted economic case remains above the current threshold.
First validation point
Validate the local cost inputs used in the economic framing.
Confidence summary
3 high-confidence, 10 medium-confidence, and 7 low-confidence assumptions are currently in play.
Assumption review
Annual frailty cohort size
1,500
Operational estimate · Medium confidence
Baseline crisis event rate
35.0%
Evidence-informed proxy · Medium confidence
Baseline non-elective admission rate
22.0%
Operational estimate · Medium confidence
Current average length of stay
6.0
Operational estimate · Medium confidence
Implementation reach rate
60.0%
Operational estimate · Medium confidence
Reduction in crisis event rate
12.0%
Illustrative default · Low confidence
Reduction in admission rate
10.0%
Illustrative default · Low confidence
Reduction in length of stay
8.0%
Illustrative default · Low confidence
Support cost per patient
£350
Operational estimate · Medium confidence
Annual effect decay
10.0%
Illustrative default · Low confidence
Annual participation / persistence drop-off
5.0%
Illustrative default · Low confidence
Cost per crisis event
£900
Operational estimate · Medium confidence
Cost per admission
£4,200
Operational estimate · Medium confidence
Cost per bed day
£400
Illustrative default · Low confidence
Costing method
Admission and crisis savings only
User override · Medium confidence
QALY gain per patient meaningfully stabilised
0.05
Evidence-informed proxy · Low confidence
Targeting mode
Broad frailty cohort
User override · Medium confidence
Time horizon
3
User override · High confidence
Discount rate
3.5%
Evidence-informed proxy · High confidence
Cost-effectiveness threshold
£20,000
Illustrative default · High confidence