Cost-effectiveness of antihyperlipemic therapy in the prevention of coronary heart disease. The case of cholestyramine
G. Oster and A. M. Epstein
Policy Analysis Inc, Brookline, Mass 02146.
Using cholestyramine as a model, we considered the cost-effectiveness of
antihyperlipemic therapy in the primary prevention of coronary heart
disease among men between 35 and 74 years of age with elevated levels of
total plasma cholesterol. Our findings indicate that the cost-effectiveness
of treatment varies substantially, ranging from about $36,000 to over $1
million per year of life saved. Cost-effectiveness was highest for younger
patients, for those with additional coronary risk factors (eg, smoking or
hypertension), and for those whose course of therapy is of
less-than-lifelong duration. Conversely, it is lowest for older patients,
for those with no additional coronary risk factors, and for those who are
treated for a lifetime. Our results suggest that pharmacologic therapy may
not be cost-effective for all patients with elevated cholesterol levels,
especially those over 65 years of age. For many younger patients,
however--those with additional coronary risk factors and more severe
elevations in cholesterol levels--the cost-effectiveness of therapy may be
comparable with other accepted medical practices.
Expanded HIV Screening in the United States: Effect on Clinical Outcomes, HIV Transmission, and Costs
Paltiel et al.
ANN INTERN MED 2006;145:797-806.
ABSTRACT
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Effectiveness of radiation therapy for older women with early breast cancer.
Smith et al.
JNCI J Natl Cancer Inst 2006;98:681-690.
ABSTRACT
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Task Force #2--the cost of prevention: can we afford it? Can we afford not to do it?
Krumholz et al.
J Am Coll Cardiol 2002;40:603-615.
FULL TEXT
Estimating the Benefits of Modifying Risk Factors of Cardiovascular Disease: A Comparison of Primary vs Secondary Prevention
Grover et al.
Arch Intern Med 1998;158:655-662.
ABSTRACT
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Treating Hyperlipidemia for the Primary Prevention of Coronary Disease: Are Higher Dosages of Lovastatin Cost-effective?
Perreault et al.
Arch Intern Med 1998;158:375-381.
ABSTRACT
| FULL TEXT
Guidelines for authors and peer reviewers of economic submissions to the BMJ
Drummond and Jefferson
BMJ 1996;313:275-283.
FULL TEXT
Cholesterol Lowering and the Use of Healthcare Resources : Results of the Scandinavian Simvastatin Survival Study
Pedersen et al.
Circulation 1996;93:1796-1802.
ABSTRACT
| FULL TEXT
Discontinuation of Antihyperlipidemic Drugs -- Do Rates Reported in Clinical Trials Reflect Rates in Primary Care Settings?
Andrade et al.
NEJM 1995;332:1125-1131.
ABSTRACT
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Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study
Grover et al.
BMJ 1995;310:975-978.
ABSTRACT
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Designing a Simpler High Blood Cholesterol Case Detection Strategy: Are the Advantages of the NCEP Protocol Worth the Complexity?
Hofer and Weissfeld
Med Decis Making 1994;14:357-368.
ABSTRACT
Evaluating Drugs after Their Approval for Clinical Use
Ray et al.
NEJM 1993;329:2029-2032.
FULL TEXT
Selection of End Points in Economic Evaluations of Coronary-heart-disease Interventions
Drummond et al.
Med Decis Making 1993;13:184-190.
ABSTRACT
COST-EFFECTIVENESS OF TREATING HIGH CHOLESTEROL
JWatch General 1987;1987:7-7.
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