Table 5.
Average cost-effectiveness ratios for cardiovascular disease interventions under multiple scenarios
Intervention description | Base-case | Undiscounted health benefitsa | 10 % coverageb | Double costc | Lower effectd | 50 % effecte |
---|---|---|---|---|---|---|
Acute myocardial infarction | ||||||
ACE-inhibitor | 7526 | 5626 | 14,718 | 7777 | 26,556 | 15,172 |
Beta-blocker | 4054 | 3031 | 7926 | 4191 | 26,556 | 8171 |
ASA | 2398 | 1792 | 4685 | 2480 | 3545 | 4831 |
Streptokinase | 2407 | 1799 | 4343 | 2855 | 3714 | 4850 |
ASA + clopidogrel | 1652 | 1235 | 3225 | 1712 | 2958 | 3327 |
ASA + streptokinase | 1345 | 1006 | 2419 | 1603 | 2015 | 2669 |
ASA + streptokinase + ACE-inhibitor | 1188 | 888 | 2133 | 1411 | 1903 | 2342 |
Primary PCI | 3013 | 2252 | 4560 | 4460 | 4833 | 5983 |
ASA + streptokinase + ACE-inhibitor + beta-blocker | 998 | 746 | 1774 | 1210 | 1839 | 1950 |
ASA + clopidogrel + PCI | 2112 | 1579 | 3171 | 2240 | 3410 | 4062 |
Acute stroke | ||||||
ASA | 39,896 | 31,586 | 75,658 | 42,135 | 99,269 | 79,449 |
Post-acute myocardial infarction | ||||||
ASA | 10,345 | 7701 | 19,853 | 11,173 | 50,593 | 19,029 |
Statin | 8822 | 6552 | 16,139 | 10,119 | 10,659 | 11,594 |
Beta-blocker | 5177 | 3844 | 9823 | 5575 | 7386 | 10,296 |
ACE-inhibitor | 4856 | 3612 | 9182 | 5264 | 6092 | 6771 |
ASA + beta-blocker | 3512 | 2610 | 6612 | 3835 | 6556 | 6793 |
ASA + beta-blocker + statin | 2717 | 2018 | 4904 | 3182 | 4351 | 4597 |
ASA + beta-blocker + statin + ACE-inhibitor | 1849 | 1373 | 3349 | 2197 | 2704 | 2908 |
Post-acute stroke | ||||||
ACE-inhibitor | 3152 | 2394 | 5642 | 3663 | 3153 | 3153 |
ASA | 2822 | 2121 | 5065 | 3264 | 9996 | 4833 |
Statin | 2397 | 1820 | 4046 | 3042 | 3427 | 4355 |
ASA + statin | 1429 | 1080 | 2382 | 1844 | 2730 | 2528 |
ASA + statin + ACE-inhibitor | 1061 | 803 | 1751 | 1386 | 1616 | 1545 |
Primary prevention of IHD and stroke | ||||||
Cholesterol lowering treatment for total chol. >6.2 mmol/l | 532 | 293 | 791 | 738 | 605 | 941 |
Cholesterol lowering treatment for total chol. >5.7 mmol/l | 557 | 311 | 676 | 888 | 636 | 1002 |
Anti-hypertension treatment for SBP >160 mmHg | 74 | 42 | 97 | 102 | 77 | 124 |
Combination drug treatment for absolute risk of CVD >35 % | 67 | 39 | 88 | 103 | 69 | 94 |
Anti-hypertension treatment for SBP >140 mmHg | 154 | 88 | 172 | 234 | 161 | 263 |
Combination drug treatment for absolute risk of CVD >25 % | 77 | 45 | 95 | 124 | 80 | 108 |
Combination drug treatment for absolute risk of CVD >15 % | 94 | 55 | 108 | 157 | 98 | 132 |
Combination drug treatment for absolute risk of CVD >5 % | 141 | 82 | 153 | 245 | 148 | 199 |
aUndiscounted health benefits
b10 % target coverage
cDouble price for drugs, procedures and laboratory test
dLower boundary of effectiveness estimate
e50 % of point estimate of effectiveness