[Cost-effectiveness of coronary heart disease prevention]

Most experts agree that prevention of coronary heart disease (CHD) should be enforced. However doubt remains about how extensively pharmacological treatment should be applied. In the presence of strong financial constraints both issues emphasize the importance of health economic analyses in this area. This article describes important principles in health economics. As the effect of preventive measures can only be recognized after a considerable time lag, a long-term perspective has to be chosen. A suitable parameter are the costs per life year saved, which can be compared between otherwise completely different procedures. The assessment of different therapies depends strongly on parameters such as relative risk reduction, discount rate and costs for prevention. However it was shown that prevention with statins and anti-hypertensive therapy can be cost-effective, as the mortality reduction and hence the increase in life expectancy can be considerable. Further research is necessary, e.g., to investigate possible reductions of other vascular diseases, to acquire more knowledge about long-term cost-consequences.