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Published on: August 9, 2024

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
PubMed

Insights

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.
Abstract

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