Health Economics Scenario Lab
StableHeart
Explore how proactive cardiovascular management in high-risk or secondary prevention populations might reduce recurrent events, hospital use, and value risk.
Scope and use note
StableHeart is an exploratory scenario sandbox. It is designed to test how changes in risk, effect, engagement, and delivery cost might influence potential clinical and economic value. It does not replace formal evaluation, forecasting, or business case development.
Signal
Above current threshold
Discounted net cost
£351,428
Cost/QALY
£48,595
Headline view
Start with the current decision signal and the main economic outputs.
Events avoided
93
Admissions avoided
56
Discounted net cost
£351,428
Discounted cost per QALY
£48,595
Return on spend
0.62x
Break-even cost per patient
£187
Required risk reduction
19.3%
Required baseline event rate
31.2%
What this suggests
The current case suggests operational benefit, but the discounted cost per QALY of £48,595 remains above the current threshold over 3 years.
Main driver
risk reduction in recurrent events
Where value comes from
Most modelled value is coming through avoided recurrent events and admissions, generating £599,710 in gross savings before programme cost is considered.
What looks fragile
The bounded uncertainty range crosses decision categories, and one-way sensitivity suggests the result is particularly exposed to risk reduction in recurrent events.
Charts
Primary chart first, with supporting views below.
Cost vs savings
Cumulative delivery cost compared with gross savings.
Assumptions
Choose a starting template, then tailor the assumptions to your local intervention.
Template summary
Default: Balanced starting assumptions for a general workshop discussion.
Quick assumptions
Share of the eligible population reached.
Share of reached patients who sustain meaningful benefit.
Core avoided-event assumption.
Analysis
Review the current case, recommendation readout, comparator snapshot, and the next checks.
Report export
Export a structured summary of the current assumptions, results, and interpretation.
Patients reached
4,017
Bed days avoided
279
Return on spend
0.62x
Recommendation summary
Conclusion
The current case suggests operational benefit, but the discounted cost per QALY of £48,595 remains above the current threshold over 3 years.
What drives it
The result is most sensitive to risk reduction in recurrent events, intervention cost per patient, and sustained engagement. In practical terms, the result depends most strongly on risk reduction in recurrent events, as well as the realism of sustained patient engagement and the strength of the link between avoided events and avoided admissions.
Fragility
The bounded uncertainty range crosses decision categories, and one-way sensitivity suggests the result is particularly exposed to risk reduction in recurrent events.
Validate next
Validate the local cost inputs used in the economic framing. Then check whether the intervention would still look worthwhile over around >10 years under locally credible assumptions.
Threshold readout
Break-even cost per patient
£187
Required risk reduction
19.3%
Break-even horizon
>10 years
Required baseline event rate
31.2%
Uncertainty readout
Low
£215,785
57 events avoided · Above current threshold
Base
£48,595
93 events avoided · Above current threshold
High
£-7,688
135 events avoided · Appears cost-saving
Top sensitivity drivers
Driver 1
Risk reduction in recurrent events
Largest ICER swing: £32,274
Driver 2
Intervention cost per patient
Largest ICER swing: £25,819
Driver 3
Sustained engagement
Largest ICER swing: £14,344
Comparator snapshot
Comparator
Lower-cost delivery
Events avoided delta
0
Admissions avoided delta
0
Discounted net cost delta
-£186,716
Headline view
Start with the current decision signal and the main economic outputs.
Events avoided
93
Admissions avoided
56
Discounted net cost
£351,428
Discounted cost per QALY
£48,595
Bed days avoided
279
Patients reached
4,017
Programme cost
£964,035
Gross savings
£599,710
What this suggests
The current case suggests operational benefit, but the discounted cost per QALY of £48,595 remains above the current threshold over 3 years.
Main driver
risk reduction in recurrent events
Where value comes from
Most modelled value is coming through avoided recurrent events and admissions, generating £599,710 in gross savings before programme cost is considered.
What looks fragile
The bounded uncertainty range crosses decision categories, and one-way sensitivity suggests the result is particularly exposed to risk reduction in recurrent events.
Return on spend
0.62x
Break-even cost per patient
£187
Required risk reduction
19.3%
Required baseline event rate
31.2%
Charts
Primary chart first, with supporting views below.
Cost vs savings
Cumulative delivery cost compared with gross savings.
Events avoided by year
Annual recurrent event reduction across the selected horizon.
Clinical impact
Headline avoided-event impact over the selected horizon.
Bounded uncertainty
Low, base, and high cases against the current threshold.
One-way sensitivity
Top drivers of discounted cost per QALY when varied one at a time.
Assumptions
Choose a starting template, then tailor the assumptions to your local intervention.
Template summary
Default: Balanced starting assumptions for a general workshop discussion.
Quick assumptions
Share of the eligible population reached.
Share of reached patients who sustain meaningful benefit.
Core avoided-event assumption.
Advanced assumptions
Analysis
Review the current case, recommendation readout, comparator snapshot, and the next checks.
Report export
Export a structured summary of the current assumptions, results, and interpretation.
Patients reached
4,017
Admissions avoided
56
Bed days avoided
279
Return on spend
0.62x
Recommendation summary
Conclusion
The current case suggests operational benefit, but the discounted cost per QALY of £48,595 remains above the current threshold over 3 years.
What drives it
The result is most sensitive to risk reduction in recurrent events, intervention cost per patient, and sustained engagement. In practical terms, the result depends most strongly on risk reduction in recurrent events, as well as the realism of sustained patient engagement and the strength of the link between avoided events and avoided admissions.
Fragility
The bounded uncertainty range crosses decision categories, and one-way sensitivity suggests the result is particularly exposed to risk reduction in recurrent events.
Validate next
Validate the local cost inputs used in the economic framing. Then check whether the intervention would still look worthwhile over around >10 years under locally credible assumptions.
Threshold readout
Break-even cost per patient
£187
Required risk reduction
19.3%
Break-even horizon
>10 years
Required baseline event rate
31.2%
Uncertainty readout
Low
£215,785
57 events avoided · Above current threshold
Base
£48,595
93 events avoided · Above current threshold
High
£-7,688
135 events avoided · Appears cost-saving
Top sensitivity drivers
Driver 1
Risk reduction in recurrent events
Largest ICER swing: £32,274
Driver 2
Intervention cost per patient
Largest ICER swing: £25,819
Driver 3
Sustained engagement
Largest ICER swing: £14,344
Comparator snapshot
Comparator
Lower-cost delivery
Events avoided delta
0
Admissions avoided delta
0
Discounted net cost delta
-£186,716
Assumption review
Eligible population
4,000
Operational estimate · Medium confidence
Baseline recurrent cardiovascular event rate
18.0%
Evidence-informed proxy · Medium confidence
Admission probability per event
60.0%
Evidence-informed proxy · Medium confidence
Average length of stay
5.0
Operational estimate · Medium confidence
Intervention reach
60.0%
Operational estimate · Medium confidence
Sustained engagement / adherence
70.0%
Evidence-informed proxy · Low confidence
Annual participation drop-off
8.0%
Illustrative default · Low confidence
Risk reduction in recurrent events
15.0%
Evidence-informed proxy · Low confidence
Annual effect decay
10.0%
Illustrative default · Low confidence
Intervention cost per patient reached
£240
Operational estimate · Medium confidence
Cost per cardiovascular event
£3,200
Evidence-informed proxy · Medium confidence
Cost per admission
£5,400
Operational estimate · Medium confidence
Cost per bed day
£420
Illustrative default · Low confidence
Costing method
Event and admission savings only
User override · Medium confidence
QALY gain per event avoided
0.08
Evidence-informed proxy · Low confidence
Targeting mode
Secondary prevention focus
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
Decision readout
Interpretation summary
The current case suggests operational benefit, but the discounted cost per QALY of £48,595 remains above the current threshold over 3 years.
What drives result
The result is most sensitive to risk reduction in recurrent events, intervention cost per patient, and sustained engagement. In practical terms, the result depends most strongly on risk reduction in recurrent events, as well as the realism of sustained patient engagement and the strength of the link between avoided events and avoided admissions.
ROI summary
Return on spend is 0.62x.
Confidence summary
3 high-confidence, 10 medium-confidence, and 6 low-confidence assumptions are currently in play.