Chronic Diseases

Chronic diseases cause nearly three-quarters of all deaths globally.

Area Lead

Dr An Duy Tran

Chronic diseases cause nearly three-quarters of all deaths globally. Cardiovascular disease such as coronary heart disease and stroke is among the leading causes of mortality and comorbidity worldwide, followed by cancers, chronic respiratory diseases and diabetes. In Australia, chronic conditions are responsible for nearly 40% of hospitalisations and contributed to nearly 90% of deaths. With the advent of the COVID-19 pandemic, prevention and treatment of chronic diseases have become more important than ever, given the profoundly negative impact of COVID-19 in people with chronic diseases.

Our team has particular expertise in health economic study design and modelling to generate data and tools to project long-term health outcomes and conduct economic evaluation of interventions for several non-communicable diseases. For example, we have been at the forefront of development of patient-level simulation models to support economic evaluations of medications for type 1 and type 2 diabetes. We have also developed prediction models for risk assessment in cardiovascular disease and conducted economic evaluations alongside clinical trials of interventions for rheumatoid arthritis, systemic sclerosis, cancer, chronic kidney disease and diabetes.

We have been collaborating with researchers, clinicians and policy makers from many medical centres, research institutes, universities and governments in Australia and other countries. Key collaborators include Royal Melbourne Hospital, St Vincent’s Hospital Melbourne, Austin Health, Western Health, St Vincent Institute for Medical Research, Australian Government Department of Health and Aged Care, University of Oxford, University of Michigan Ann Arbor and The Swedish Institute for Health Economics.

Related Research Staff

Prof Kim Dalziel, Prof Philip Clarke, A/Prof Ilias Goranitis, Dr Xinyang Hua, Dr Michelle Tew, Mr Paul Amores, Mr Liam Fernando-Canavan

Project Listing

  • Development of tools and a framework for economic evaluations of interventions for diabetes and its complications in the Australian healthcare system setting
  • Economic evaluation of immunotherapies for type 1 diabetes
  • Economic evaluation of Automated Insulin Delivery System for type 1 diabetes
  • Economic evaluation of Flash glucose Monitoring in Indigenous Australians with type 2 diabetes
  • Economic evaluation of Future Health Today Program – a software platform for chronic disease management in primary care
  • Development of a patient-level simulation model to estimate lifetime cardiovascular health outcomes in patients with chronic kidney disease
  • Economic evaluation of intravenous anaesthesia for cancer surgery (the VAPOR-C trial)
  • Early economic evaluation of the use of robots and 3D-printed prosthesis for surgical treatment of osteosarcoma (Just-In-Time Patient Specific Tumour Implants project)
  • Quality of life analysis in the CKD-FIX trial: Controlled trial of slowing of Kidney Disease progression From the Inhibition of Xanthine oxidase

Selected Publications


Nghiem N, Atkinson J, Nguyen BP, TRAN-DUY A, Wilson N. Predicting high health-cost users among people with cardiovascular disease using machine learning and nationwide linked social administrative datasets. Health Economics Review 2023;13(1):9


TEW M, Willis M, …, TRAN-DUY A, …, CLARKE P. Exploring Structural Uncertainty and Impact of Health State Utility Values on Lifetime Outcomes in Diabetes Economic Simulation Models: Findings from the Ninth Mount Hood Diabetes Quality-of-Life Challenge. Medical Decision Making 2022;42:599–611.

CLARKE PM, TRAN-DUY A, et al. The comparative mortality of an elite group in the long run of history: an observational analysis of politicians from 11 countries. European Journal of Epidemiology 2022;37:891-9.

Shan LL, Yang LS, TEW M, et al. Quality of Life in Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis. European Journal of Vascular and Endovascular Surgery. 2022 Aug 8.

HUA X, Catchpool M, CLARKE P, .., DALZIEL K. Cost‐effectiveness of professional‐mode flash glucose monitoring in general practice among adults with type 2 diabetes: Evidence from the GP‐OSMOTIC trial. Diabetic Medicine. 2022 Mar;39(3):e14747.


TRAN‐DUY A, Morrisroe K, CLARKE P, …, et al. Cost‐Effectiveness of Combination Therapy for Patients With Systemic Sclerosis–Related Pulmonary Arterial Hypertension. Journal of the American Heart Association 2021;10:e015816.

TRAN-DUY A, KNIGHT J, CLARKE P, et al. Development of a life expectancy table for individuals with type 1 diabetes. Diabetologia 2021;64:2228-36.

Vu M, CARVALHO N, CLARKE PM, Buchbinder R, TRAN-DUY A. Impact of Comorbid Conditions on Healthcare Expenditure and Work-related Outcomes in Patients with Rheumatoid Arthritis. The Journal of Rheumatology 2021;48:1221-9.

HUA X, Gray A, Wolstenholme J, CLARKE P, et al. Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the United Kingdom cohort of the international subarachnoid aneurysm trial. Neurosurgery. 2021 Feb;88(2):252.


TRAN‐DUY A, KNIGHT J, …, CLARKE P. A patient-level model to estimate lifetime health outcomes of patients with type 1 diabetes. Diabetes Care 2020;43:1741-9.

TRAN-DUY A, McDermott R, KNIGHT J, HUA X, …, CLARKE P. Development and Use of Prediction Models for Classification of Cardiovascular Risk of Remote Indigenous Australians. Heart, Lung and Circulation 2020;29:374-83.

TEW M, DALZIEL K, CLARKE P, Smith A, Choong PF, Dowsey M. Patient-reported outcome measures (PROMs): can they be used to guide patient-centered care and optimize outcomes in total knee replacement?. Quality of Life Research. 2020 Dec;29:3273-83.

HUA X, Lung TW, Woodward M, …, CLARK P. Self‐rated health scores predict mortality among people with type 2 diabetes differently across three different country groupings: findings from the ADVANCE and ADVANCE‐ON trials. Diabetic Medicine. 2020 Aug;37(8):1379-85.

Peng Z, Hou X, Huang Y, …, HUA X. Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China. BMC Cancer. 2020 Dec;20:1-8.


TRAN‐DUY A, Connell NJ, et al. Use of proton pump inhibitors and risk of iron deficiency: a population‐based case–control study. Journal of Internal Medicine 2019;285:205-14.

Kent S, Becker F, Feenstra T, TRAN-DUY A, Schlackow I, TEW M, …, CLARKE P. The Challenge of Transparency and Validation in Health Economic Decision Modelling: A View from Mount Hood. PharmacoEconomics 2019.

TEW M, Dowsey MM, Choong A, Choong PF, CLARKE P. Co-morbidities and sex differences in long-term quality-of-life outcomes among patients with and without diabetes after total knee replacement: Five-year data from registry study. Journal of Clinical Medicine. 2019 Dec 19;9(1):19.


TRAN-DUY A, …, CLARKE P, et al. An Economic Evaluation of Stopping Versus Continuing Tumor Necrosis Factor Inhibitor Treatment in Rheumatoid Arthritis Patients With Disease Remission or Low Disease Activity Results From a Pragmatic Open-Label Trial. Arthritis & Rheumatology 2018;70:1557-64.

Palmer AJ, Si L, TEW M, HUA X, …, TRAN-DUY A, CLARKE P. Computer Modeling of Diabetes and Its Transparency: A Report on the Eighth Mount Hood Challenge. Value In Health 2018;21:724-31.