Use of a coronary heart disease simulation model to evaluate the costs and effectiveness of drugs for the prevention of heart disease

A discrete event simulation model of the patient pathways in the treatment of coronary heart disease (CHD) was used to quantify the health gains and costs associated with increasing secondary prevention drugs prescription for patients with CHD based on the level recommended in the National Service Framework for the UK. A Gompertz distribution was sampled for time to failure (death or non–fatal heart attack). The time to failure was modified in relation to the reduced risk of failure for those on the relevant drugs. The results from the model were validated against national data. Increasing the levels of prescription of secondary prevention drugs to those patients with CHD might prevent 100 deaths per million population per year and cost an additional £4 million per million population per year. With cost per life year saved of £5520, this appears good value for money compared with other health technologies.