Footnotes:

¹ Early detection and diagnosis

This section includes GP appointments for symptoms, heart check, referral and results; ECG; blood tests including kidney function and electrolytes; BNP/NT-proBNP testing if used; echocardiogram; chest X-ray; CT or other imaging where clinically appropriate; and repeat testing if symptoms change.

The estimate is built from the Phase II line-item model, including GP visits modelled at a $50 out-of-pocket gap per non-bulk-billed visit; ECG ($0-$30); blood tests ($0-$100 for HF and $0-$200 for HF + CKD); BNP/NT-proBNP ($0-$100); echocardiogram ($0-$150); chest X-ray ($0-$80); CT/other imaging where clinically appropriate ($0-$300); and repeat testing if symptoms change.

Relevant reference links include MBS item 66830 for BNP/NT-proBNP testing, MBS item 55126 for transthoracic echocardiography, and Kidney Health Australia/Deloitte CKD modelling for CKD monitoring assumptions.

² Emergency and hospital care

This section assumes one ambulance event and one public hospital pathway for a Medicare-eligible public patient. Public ED presentation and public hospital admission are modelled as $0 direct hospital bill, but this does not mean the event is cost-free to the household. Ambulance, transport, parking, family travel, meals and possible readmission-related costs are captured separately.

The ambulance estimate uses a rounded $600 proxy due to state variation. NSW Ambulance lists a call-out fee plus per-kilometre charge from 1 July 2025; actual costs may be $0 or higher depending on state, ambulance cover, concession status and distance.
Relevant reference links include the Australian Government overview on Medicare billing in public hospitals and NSW Ambulance accounts and fees. Private hospital ED fees, private hospital excesses and private inpatient costs are excluded from the base case.

³ Ongoing care and medicines

This section includes GP follow-up and medication review, cardiologist appointments, additional specialist appointments where relevant, repeat pathology monitoring, repeat cardiac imaging if clinically required, PBS medicines, non-PBS pharmacy costs, cardiac rehabilitation, allied health, at-home monitoring equipment and recommended adult vaccinations.

The GP visit assumption has been strengthened using SHAPE data. The SHAPE healthcare-use study found people with definite or probable heart failure attended GP practices 14.4 times per year on average, with frequency increasing with comorbidity burden. The model therefore uses 12-14 GP follow-up/medication review visits for HF and 18-20 visits for HF + CKD.

Medicine costs use the 2026 general PBS co-payment of $25 per script for Medicare card holders, with a higher medicine burden modelled for people living with both heart failure and CKD. Pharmacy costs also allow for non-PBS, over-the-counter and complementary medicines, delivery, dose aids and brand premiums. Vaccination costs are included as a conservative modelled line item because some vaccines may be recommended but not fully funded for every adult, depending on age and eligibility.

Relevant reference links include the SHAPE healthcare-use study in AJGP, the SHAPE epidemiology study, PBS co-payment information, Australian Government adult immunisation guidance, Medical Costs Finder, and Kidney Health Australia/Deloitte CKD modelling for CKD and nephrology assumptions.

⁴ Work, travel and household impacts

This section captures household costs that may not appear on a medical bill: time off work for appointments, tests and recovery; unpaid carer time; transport to appointments; parking; minor home modifications or mobility aids; and paid domestic support where required.

Work and carer time are modelled as a productivity/time burden, not always a direct cash payment. The calculation uses an Australian average full-time earnings proxy to estimate the value of missed work time or unpaid carer time. This means the figure will apply differently depending on whether the person is working, retired, casually employed, self-employed, supported by family, or relying on unpaid care.

Transport and parking are modelled using conservative metropolitan assumptions. Costs may be higher for people in regional or rural areas who need to travel further for cardiology, imaging, nephrology, rehabilitation or other specialist care.

Relevant reference links include Australian Bureau of Statistics Average Weekly Earnings for wage-based proxy calculations and Kidney Health Australia/Deloitte CKD modelling for CKD-related transport, non-prescription and household cost assumptions.

The model is based on:

• an adult Australian Medicare card holder
• living in a major city
• accessing care mainly through the public system
• some mixed-billing out-of-pocket costs
• moderate heart failure in the first 12 months after diagnosis or hospitalisation
• moderate-to-advanced CKD requiring additional monitoring and nephrology input in the HF + CKD scenario
• no dialysis in the base-case HF + CKD estimate

Actual costs may be lower for people who are bulk billed, have concession cards, have ambulance cover, receive care entirely through public outpatient clinics, or do not require all tests, appointments or supports included in the model.

Actual costs may be higher for people who use private specialists or private hospitals, pay private hospital ED fees or excesses, require more frequent testing or imaging, live in regional or rural areas, need paid care or home support, experience readmission, or live with multiple comorbidities.