Aims To assess the cost-effectiveness of three different treatment strategies for the use of ACE inhibitors after myocardial infarction.
These were (a) a high risk (AIRE type) strategy, (b) an intermediate risk (SAVE type) strategy, and (c) initial, short-term treatment of all patients followed by long-term treatment according to (a) or (b).
Methods and results Incremental costs per life year gained were calculated for each of the above scenarios.
The most optimistic cost per life year gained over 10 years, for (a) was £1752 and for (b) was £2962.
Strategy (c) increased the cost per life year gained of (a) to £2017 and (b) to £3110.
The incremental cost-effectiveness ratio was found to be very sensitive to drug cost.
Conclusions If a low cost ACE inhibitor is used, initial treatment of relatively unselected patients followed by long-term treatment of those at high and medium risk maximizes benefit at an acceptable cost.
Use of an ACE inhibitor after myocardial infarction is very cost-effective by comparison with many other treatments.
Mots-clés Pascal : Infarctus, Myocarde, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Inhibiteur enzyme, Analyse coût efficacité, Economie santé, Chimiothérapie, Traitement, Efficacité traitement, Homme, Vasodilatateur, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Angiotensin converting enzyme
Mots-clés Pascal anglais : Infarct, Myocardium, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Enzyme inhibitor, Cost efficiency analysis, Health economy, Chemotherapy, Treatment, Treatment efficiency, Human, Vasodilator agent, Cardiovascular disease, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0478665
Code Inist : 002B02F04. Création : 03/02/1998.