The cost-effectiveness of an early interventional strategy in non-ST-elevation acute coronary syndrome based on the RITA 3 trial.
BACKGROUND: Evidence suggests that an early interventional strategy for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can improve health outcomes but also increase costs when compared with a conservative strategy. OBJECTIVE: The aim of this study was to assess the cost-effectiven...
| Publicado en: | Heart Vol. 94; no. 6; pp. 717 - 724 |
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| Autores principales: | , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BMJ Publishing Group
Jun2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105747787&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105747787 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13556037 1XU jtl: Heart issn: 13556037 maglogo: N pubinfo: dt: Jun2008 vid: 94 iid: 6 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 105747787 2009939365 10.1136/hrt.2007.127340 NLM18032459 105747787 ppf: 717 ppct: 7 formats: tig: atl: The cost-effectiveness of an early interventional strategy in non-ST-elevation acute coronary syndrome based on the RITA 3 trial. aug: au: Henriksson M Epstein DM Palmer SJ Sculpher MJ Clayton TC Pocock SJ Henderson RA Buxton MJ Fox KA affil: Centre for Health Economics, University of York, UK. martin.henriksson@ihs.liu.se sug: subj: Coronary Angiography Economics Life Table Method Acute Coronary Syndrome Economics Aged Aged, 80 and Over Angina, Unstable Economics Angina, Unstable Therapy Clinical Trials Cost Benefit Analysis Economics Costs and Cost Analysis Cox Proportional Hazards Model Diabetic Angiopathies Therapy Female Male Middle Age Multicenter Studies Acute Coronary Syndrome Mortality Acute Coronary Syndrome Therapy Human Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: BACKGROUND: Evidence suggests that an early interventional strategy for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can improve health outcomes but also increase costs when compared with a conservative strategy. OBJECTIVE: The aim of this study was to assess the cost-effectiveness of an early interventional strategy in different risk groups from a UK health-service perspective. DESIGN: Decision-analytic model based on randomised clinical trial data. MAIN OUTCOME MEASURES: Costs in UK Sterling at 2003/2004 prices and quality-adjusted life years (QALYs) combined into an incremental cost-effectiveness ratio. METHODS: Data from the third Randomised Intervention Trial of unstable Angina (RITA 3) was employed to estimate rates of cardiovascular death and myocardial infarction, costs and health-related quality of life. Cost-effectiveness was estimated over patients' lifetimes within the decision-analytic model. RESULTS: The mean incremental cost per QALY gained for an early interventional strategy was approximately 55,000 pounds sterling, 22,000 pounds sterling and 12,000 pounds sterling for patients at low, intermediate and high risk, respectively. The early interventional strategy is approximately 1%, 35% and 95% likely to be cost-effective for patients at low, intermediate and high risk, respectively, at a threshold of 20,000 pounds sterling per QALY. The cost-effectiveness of early intervention in low-risk patients is sensitive to assumptions about the duration of the treatment effect. CONCLUSION: An early interventional strategy in patients presenting with NSTE-ACS is likely to be considered cost-effective for patients at high and intermediate risk, but this is less likely to be the case for patients at low risk. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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