An economic evaluation of cardiovascular disease prevention in primary care

This study is an analysis using economic modelling of cardiovascular disease prevention in primary care. The costs of cardiovascular disease prevention are considered from the perspective of the health service. The benefits of cardiovascular disease prevention are measured as the number of major cardiovascular events prevented over a five-year time horizon. The study population consists of adults in the Health Survey for England 1998 who are free from cardiovascular disease. The analysis estimates the cost-effectiveness of strategies for identification of patients for prevention of cardiovascular disease and identifies the most efficient identification strategy. The analysis estimates the cost-effectiveness of a number of preventive interventions, then ranks these interventions by their cost-effectiveness and calculates the incremental cost-effectiveness of adding additional interventions. Finally the analysis estimates the efficiency characteristics of different strategies for identification and treatment in the study population. An extensive sensitivity analysis of the findings is carried out. There are three main findings. First there are more efficient selection strategies than those currently recommended. Second, cost-effectiveness rankings of preventive interventions are robust. Third, prevention strategies are more cost-effective when treatment eligibility criteria are informed by cost-effectiveness analysis