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Decision-making using absolute cardiovascular risk reduction and incremental cost-effectiveness ratios: a case study.
J A Ker1, H Oosthuizen, P Rheeder
1Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Cardiovascular Journal of Africa
|June 3, 2008
Summary
This study modeled cardiovascular risk reduction strategies using the Framingham risk score. High-dose statins offered the most cost-effective risk reduction per percentage point.
Area of Science:
- Cardiovascular Risk Assessment
- Health Economics
- Pharmacoeconomics
Background:
- Clinical guidelines increasingly use multifactorial assessment for cardiovascular risk identification.
- The Framingham risk score is a common tool for calculating absolute cardiovascular risk.
- Cost-effectiveness analysis is crucial for evaluating treatment strategies, but can be complex for clinicians.
Purpose of the Study:
- To model the impact of various drug treatments on absolute cardiovascular risk using a simulated patient.
- To compare the cost-effectiveness of different therapeutic strategies for cardiovascular risk reduction.
Main Methods:
- Calculated the Framingham risk score for a hypothetical patient.
- Initiated drug treatments sequentially and recalculated the risk score after each intervention.
- Utilized South African single-exit drug pricing to determine the cost per percentage of cardiovascular risk reduction.
Main Results:
- Antihypertensive therapy yielded a cost-effectiveness ratio of R21.35 per % risk reduction.
- Statin therapy showed a ratio of R22.93 per % risk reduction, while high-dose statins were R12.81 per % risk reduction.
- Combined therapies and multi-drug regimens offered varying cost-effectiveness, with one combination achieving R17.18 per % risk reduction.
Conclusions:
- The study presents a model for comparing the cost-effectiveness of diverse cardiovascular risk reduction strategies.
- This approach aids clinicians in evaluating therapeutic options based on cost per unit of risk reduction.
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