Cost-effectiveness of optimized adherence to prevention guidelines in European patients with coronary heart disease: Results from the EUROASPIRE IV survey

International Journal of Cardiology
Delphine De SmedtD De Bacquer

Abstract

This study aims to assess the cost-effectiveness of optimized guideline adherence in patients with a history of coronary heart disease. An individual-based decision tree model was developed using the SMART risk score tool which estimates the 10-year risk for recurrent vascular events in patients with manifest cardiovascular disease (CVD). Analyses were based on the EUROASPIRE IV survey. Outcomes were expressed as an incremental cost-effectiveness ratio (ICER). Data from 4663 patients from 13 European countries were included in the analyses. The mean estimated 10-year risk for a recurrent vascular event decreased from 20.13% to 18.61% after optimized guideline adherence. Overall, an ICER of 52,968€/QALY was calculated. The ICER lowered to 29,093€/QALY when only considering high-risk patients (≥20%) with decreasing ICERs in higher risk patients. Also, a dose-response relationship was seen with lower ICERs in older patients and in those patients with higher risk reductions. A less stringent LDL target (<2.5 mmol/L vs. <1.8 mmol/L) lowered the ICER to 32,591€/QALY and intensifying cholesterol treatment in high-risk patients (≥20%) instead of high-cholesterol patients lowered the ICER to 28,064€/QALY. An alternative method, applying...Continue Reading

Citations

Jan 17, 2020·Expert Review of Cardiovascular Therapy·Dhruv MahttaSalim S Virani
Sep 21, 2019·European Journal of Preventive Cardiology·Roberto Fe PedrettiSimona Sarzi Braga
Sep 14, 2021·Current Medical Research and Opinion·Fiorenzo SantoleriAlberto Costantini

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