Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010.
dc.contributor.author | Bennett, Kathleen | |
dc.contributor.author | Kabir, Zubair | |
dc.contributor.author | Barry, Michael | |
dc.contributor.author | Tilson, Lesley | |
dc.contributor.author | Fidan, Dogan | |
dc.contributor.author | Shelley, Emer | |
dc.contributor.author | Capewell, Simon | |
dc.date.accessioned | 2009-11-30T16:15:18Z | |
dc.date.available | 2009-11-30T16:15:18Z | |
dc.date.issued | 2009-01 | |
dc.identifier.citation | Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010. 2009, 12 (1):10-5notValue Health | en |
dc.identifier.issn | 1524-4733 | |
dc.identifier.pmid | 19040564 | |
dc.identifier.doi | 10.1111/j.1524-4733.2008.00398.x | |
dc.identifier.uri | http://hdl.handle.net/10147/87114 | |
dc.description.abstract | OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000/LYG), followed by the statins for secondary prevention (< euro 6500/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure. | |
dc.language.iso | en | en |
dc.relation.url | https://auth.athensams.net/?ath_returl=http%3a%2f%2fsearch.ebscohost.com%2fLogin.aspx%3fdirect%3dtrue%26authtype%3dAthens%26authtype%3dAthens%26db%3dmnh%26jid%3dFSN%26scope%3dsite&ath_dspid=EBSCO | en |
dc.title | Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010. | en |
dc.contributor.department | Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland. bennettk@tcd.ie | en |
dc.identifier.journal | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research | en |
html.description.abstract | OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000/LYG), followed by the statins for secondary prevention (< euro 6500/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure. |