scholarly journals Cost effectiveness of cardiovascular disease prevention strategies: a perspective on EU food based dietary guidelines

2001 ◽  
Vol 4 (2b) ◽  
pp. 711-715 ◽  
Author(s):  
Eric Brunner ◽  
David Cohen ◽  
Lynn Toon
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Healthy Eating ◽  
Health Gain ◽  
Cost Effective ◽  
Dietary Guidelines ◽  
Member States ◽  
Eu Member States ◽  
Health Gains ◽  
Prevention Of Cardiovascular Disease

AbstractFor policymakers considering strategy options for the prevention of cardiovascular disease (CVD) the distinction between effectiveness and cost effectiveness is critical. When cost limitations apply, an evaluation of cost effectiveness is essential if a rational decision is to be made. Policy changes and resource reallocation have opportunity costs, and therefore it is necessary to compare the cost of health gains achievable by means of different policies. Here the broad question is: How cost effective are diet change strategies compared to other measures aimed at reducing cardiovascular disease in EU member states?An overview of published studies of cost effectiveness in the primary and secondary prevention of cardiovascular disease was conducted. Few comprehensive studies were available.Estimated costs per life year gained were as follows: population-based healthy eating £14–560; smoking cessation £300–790; nurse screening and life style advice £900 (minimum); simvastatin (HMGCoA reductase inhibitor) £6200–11 300. Cost effectiveness is dependent on the underlying level of CVD risk in the target population, and the duration of the achieved alterations in behaviours and risk factors.The limited evidence from these studies tends to support the view that health protection strategies which promote healthy eating are likely to be more cost-effective than strategies involving modern cholesterol-lowering drugs, screening and advice in primary care, and are comparable to or less expensive per year of life saved than anti-smoking strategies. Given the considerable diversity in food habits, health care and public health systems among current and prospective EU member states, careful appraisal of the policy options within each member state is desirable to ensure that health gain is maximised. EU wide food based dietary guidelines are potentially the basis of large health gains in Europe, and cost-effectiveness studies tend to support their adoption.

Primary prevention of cardiovascular disease: Cost-effectiveness comparison

2007 ◽  
Vol 23 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Oscar H. Franco ◽  
Arno J. der Kinderen ◽  
Chris De Laet ◽  
Anna Peeters ◽  
Luc Bonneux
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Smoking Cessation ◽  
Heart Disease ◽  
Cost Effectiveness ◽  
Primary Prevention ◽  
Risk Reduction ◽  
Cost Effective ◽  
Life Years ◽  
Prevention Of Cardiovascular Disease

Objectives: The aim of this study was to evaluate the cost-effectiveness of four risk-lowering interventions (smoking cessation, antihypertensives, aspirin, and statins) in primary prevention of cardiovascular disease.Methods: Using data from the Framingham Heart Study and the Framingham Offspring study, we built life tables to model the benefits of the selected interventions. Participants were classified by age and level of risk of coronary heart disease. The effects of risk reduction are obtained as numbers of death averted and life-years saved within a 10-year period. Estimates of risk reduction by the interventions were obtained from meta-analyses and costs from Dutch sources.Results: The most cost-effective is smoking cessation therapy, representing savings in all situations. Aspirin is the second most cost-effective (€2,263 to €16,949 per year of life saved) followed by antihypertensives. Statins are the least cost-effective (€73,971 to €190,276 per year of life saved).Conclusions: A cost-effective strategy should offer smoking cessation for smokers and aspirin for moderate and high levels of risk among men 45 years of age and older. Statin therapy is the most expensive option in primary prevention at levels of 10-year coronary heart disease risk below 30 percent and should not constitute the first choice of treatment in these populations.

scholarly journals Exercise programmes to prevent falls among older adults: modelling health gain, cost-utility and equity impacts

2018 ◽  
Vol 25 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Eamonn Deverall ◽  
Giorgi Kvizhinadze ◽  
Frank Pega ◽  
Tony Blakely ◽  
Nick Wilson
Keyword(s):  
Cost Effectiveness ◽  
Cochrane Review ◽  
Health Gain ◽  
Cost Effective ◽  
Exercise Programme ◽  
Falls Prevention ◽  
System Perspective ◽  
Home Based ◽  
Health Gains ◽  
Life Years

BackgroundSome falls prevention interventions for the older population appear cost-effective, but there is uncertainty about others. Therefore, we aimed to model three types of exercise programme each running for 25 years among 65+ year olds: (i) a peer-led group-based one; (ii) a home-based one and (iii) a commercial one.MethodsAn established Markov model for studying falls prevention in New Zealand (NZ) was adapted to estimate incremental cost-effectiveness ratios (ICERs) in cost per quality-adjusted life-years (QALYs) gained. Detailed NZ experimental, epidemiological and cost data were used for the base year 2011. A health system perspective was taken and a discount rate of 3% applied. Intervention effectiveness estimates came from a Cochrane Review.ResultsThe intervention generating the greatest health gain and costing the least was the home-based exercise programme intervention. Lifetime health gains were estimated at 47 100 QALYs (95%uncertainty interval (UI) 22 300 to 74 400). Cost-effectiveness was high (ICER: US$4640 per QALY gained; (95% UI US$996 to 10 500)), and probably more so than a home safety assessment and modification intervention using the same basic model (ICER: US$6060). The peer-led group-based exercise programme was estimated to generate 42 000 QALYs with an ICER of US$9490. The commercially provided group programme was more expensive and less cost-effective (ICER: US$34 500). Further analyses by sex, age group and ethnicity (Indigenous Māori and non-Māori) for the peer-led group-intervention showed similar health gains and cost-effectiveness.ConclusionsImplementing any of these three types of exercise programme for falls prevention in older people could produce considerable health gain, but with the home-based version being likely to be the most cost-effective.

scholarly journals Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study (Preprint)

2020 ◽  
Author(s):  
Anja Mizdrak ◽  
Kendra Telfer ◽  
Artur Direito ◽  
Linda J Cobiac ◽  
Tony Blakely ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Health Gain ◽  
Cost Effective ◽  
Health Impacts ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Smartphone Apps ◽  
Health Gains

BACKGROUND Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. OBJECTIVE We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps. METHODS We used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs. RESULTS The modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention. CONCLUSIONS A mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.

scholarly journals Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study

10.2196/18014 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e18014
Author(s):  
Anja Mizdrak ◽  
Kendra Telfer ◽  
Artur Direito ◽  
Linda J Cobiac ◽  
Tony Blakely ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Health Gain ◽  
Cost Effective ◽  
Health Impacts ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Smartphone Apps ◽  
Health Gains

Background Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. Objective We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps. Methods We used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs. Results The modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention. Conclusions A mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.

scholarly journals PCV93 the Polypill in the Primary Prevention of Cardiovascular Disease: Cost-Effectiveness in the Dutch Population

2011 ◽  
Vol 14 (7) ◽  
pp. A381
Author(s):  
P.F. Van Gils ◽  
H.H. Hamberg-van Reenen ◽  
E. Over ◽  
G.A. de Wit ◽  
M. van den Berg ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Primary Prevention ◽  
Dutch Population ◽  
Disease Cost ◽  
Prevention Of Cardiovascular Disease

scholarly journals The polypill in the primary prevention of cardiovascular disease: cost-effectiveness in the Dutch population

BMJ Open ◽  
2011 ◽  
Vol 1 (2) ◽  
pp. e000363-e000363 ◽  
Author(s):  
P. F. van Gils ◽  
E. A. B. Over ◽  
H. H. Hamberg-van Reenen ◽  
G. A. de Wit ◽  
M. van den Berg ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Primary Prevention ◽  
Dutch Population ◽  
Disease Cost ◽  
Prevention Of Cardiovascular Disease
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