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Cost-Effectiveness of Cardiovascular Prevention Programs in Spain

Published online by Cambridge University Press:  10 March 2009

Pedro Plans-rubió
Affiliation:
General Direction of Public Health, Barcelona

Abstract

Individual programs for prevention of cardiovascular disease include dietary and drug treatment of hypercholesterolemia, hypertension treatment, and smoking cessation therapies. In this study, the cost-effectiveness of available cardiovascular prevention programs was assessed in Spain in terms of net cost per life-year gained (LYG). Cost-effectiveness ratios ranged from US $2,600 to $80,000 per LYG in men and from $4,500 to $230,000 per LYG in women. In men aged 40–59 years, the ranking of increasing cost-effectiveness was: smoking cessation ($2,608–3,738 per LYG); treatment of moderate and severe hypertension ($8,564–38,678 per LYG); treatment of mild hypertension ($11,906–59,840 per LYG); dietary treatment ($16,143–20,158 per LYG); and drug treatment of hypercholesterolemia ($33,850–81,010 per LYG). In women, the ranking list was: smoking cessation ($4,482–5,756 per LYG), treatment of moderate and severe hypertension ($9,585–57,983 per LYG), treatment of mild hypertension ($15,248–86,075 per LYG), dietary treatment ($57,175–62,154 per LYG); and drug treatment of hypercholesterolemia ($104,100–259,150 per LYG).

Type
General Essays
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Abbott, R. D., & McGee, D.The probability of developing certain cardiovascular disease in eight years at specified values of some characteristics. In Kannel, W. B., Wolf, P. A., & Garrisson, R. J., (eds.), Bethesda: U.S. Department of Health, Education, and Welfare, 1987.Google Scholar
2.Catálogo de especialidades farmacéuticas, 1992. Madrid: Publicaciones del Consejo General de Colegios Oficiales de Farmacéuticos, 1992.Google Scholar
3.Consenso para el control de la colesterolemia en Espana. Clin Invest Arteriosclerosis, 1989, 1, 5561.Google Scholar
4.Cummings, S. R., Rubin, S. M., & Oster, G.The cost-effectiveness of counseling smokers to quit. Journal of the American Medical Association, 1989, 261, 7579.CrossRefGoogle ScholarPubMed
5.Departament de Sanitat. Pla de salut. Barcelona: Departament de Sanitat, 1991.Google Scholar
6.Edelson, J. T., Weinstein, M. C., Tosteson, A. N., et al. Long-term cost-effectiveness of various initial monotherapies for mild to moderate hypertension. Journal of the American Medical Association, 1990, 263, 408–13.Google ScholarPubMed
7.Glick, H., Hayse, J. F., Thomson, D., et al. A model for evaluating the cost-effectiveness of cholesterol-lowering treatment. Philadelphia: Leonard Davis Institute of Health Economics, University of Pennsylvania, 1990.Google Scholar
8.Goldman, L., Weinstein, M. C., Goldman, P. A., & Williams, L. W.Cost-effectiveness of HMG-CoA reductase inhibition for primary and secondary prevention of coronary heart disease. Journal of the American Medical Association, 1991, 265, 1145–51.CrossRefGoogle ScholarPubMed
9.Grover, S. A., Abrahamowicz, M., Joseph, L., et al. The benefits of treating hyperlipidemia to prevent coronary heart disease: Estimating changes in life expectancy and morbidity.Google Scholar
10.INSALUD. Informe ecóndmico-funcional de las Instituciones Sanitarias, 1987–110. Madrid: Ministerio de Sanidad y Consumo, 1992.Google Scholar
11.Johannesson, M.The cost-effectiveness of the switch towards more expensive antihypertensive drugs. Health Policy, 1994, 28, 113.CrossRefGoogle ScholarPubMed
12.Johannesson, M., & Weinstein, M. C.On the decision rules of cost-effectiveness analysis. Journal of Health Economics, 1993, 12, 459–67.CrossRefGoogle ScholarPubMed
13.Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Archives of Internal Medicine, 1993, 153, 154–83.CrossRefGoogle Scholar
14.Kinosian, B., & Eisenberg, J. M.Cutting into cholesterol: Cost-effective alternatives for treating hypercholesterolemia. Journal of the American Medical Association, 1988, 259, 2249–54.CrossRefGoogle ScholarPubMed
15.Kristiansen, I., Eggen, A., & Thelle, D.Cost effectiveness of incremental programmes for lowering serum cholesterol concentration: Is individual intervention worthwhile? British Medical Journal, 1991, 302, 1119–22.CrossRefGoogle Scholar
16.Oster, G., & Epstein, A.Primary prevention of coronary heart disease: The economic benefits of lowering serum cholesterol. Americal Journal of Public Health, 1986, 76, 647–56.CrossRefGoogle ScholarPubMed
17.Oster, G., Huse, D. M., Delae, T. E., & Colditz, G. A. Cost-effectiveness of nicotine gum as an adjunct to physician’s advice against cigarrete smoking. Journal of the American Medical Association, 1986, 1315–18.CrossRefGoogle Scholar
18.Pharoah, P. D. P., & Hollingworth, W.Cost-effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: Life table method applied to health authority population. British Medical Journal, 1996, 312, 1443–48.CrossRefGoogle ScholarPubMed
19.Plans, P.Cost-effectiveness of dietary treatment of hypercholesterolemia. Public Health, 1997, 111, 4350.Google Scholar
20.Plans, P., Navas, E., Tarin, A., et al. Coste-efectividad de los metodos de cesación tabáquica. Medicina Clinica (Bare), 1994, 104, 4565.Google Scholar
21.Plans, P., Pardell, H., & Salleras, L.Epidemiology of cardiovascular disease risk factors in Catalonia (Spain). European Journal of Epidemiology, 1993, 9, 381–89.CrossRefGoogle ScholarPubMed
22.Plans, P., & Rovira, J.Estudio coste-efectividad de los tratamientos farmacológicos hipolipemiantes. Medicina Clinica (Barc), 1995, 105, 327–33.Google Scholar
23.Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 individuals with coronary heart disease: The Scandinavian simvastatin survival study. Lancet, 1994, 344, 1383–89.Google Scholar
24.Sheperd, J., Cobbe, S. M., Ford, I., et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. New England Journal of Medicine, 1995, 333, 1301–07.CrossRefGoogle Scholar
25.Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. Journal of the American Medical Association, 1993, 269, 3015–23.CrossRefGoogle Scholar
26.Weinstein, M. C.Principles of cost-effectiveness resource allocation in health care organizations. International Journal of Technology Assessment in Health Care, 1990, 6, 93103.CrossRefGoogle ScholarPubMed
27.Weinstein, M. C., & Stasson, W. B.Cost-effectiveness of interventions to prevent or treat coronary heart disease. Annual Review of Public Health, 1985, 6, 3143.CrossRefGoogle ScholarPubMed
28.WHO Expert Committee. Prevention of coronary heart disease. WHO Technical Report Series No. 678. Geneve: WHO, 1982.Google Scholar