Abstract
Despite concerted clinical and public health efforts [1] to improve coronary heart disease (CHD), cardiovascular disease (CVD) remains the number one killer in Western industrialized societies. More than $158 billion in the United States alone is spent on the prevention and treatment of CVD and it continues to impose a formidable burden on both the U.S. and European health-care systems. By one U.S. estimate [2] direct medical expenses in 1997 will approach $47.5 billion for CHD, $26.2 billion for stroke, and $21.8 billion for hypertension. Most of the direct medical expenses are from the costs of hospitalization and revascularization procedures.
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References
Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA 1993; 269: 3015–23.
American Heart Association. Heart and Stroke Facts: 1997 Statistical Supplement. Dallas, Tex: American Heart Association, 1997.
Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian simvastatin survival study. Lancet 1994; 344: 1383–89.
Sacks FM, Pfeffer MA, Moye LA, et al. for the Cholesterol and Recurrent Events Trial Investigators. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996; 1001–09.
Shepherd J, Cobbe SM, Ford I, et al. for the West of Scotland Coronary Prevention Study Group. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995; 333: 1301–07.
th Bethesda Conference: Matching the Intensity of Risk Factor Management with the Hazard for Coronary Disease Events; September 14–15, 1995. J Am Coll Cardiol 1996; 27: 957–1047.
Eisenberg JM. Clinical economics: A guide to economic analysis of clinical practices. JAMA 1989; 262: 2879–86.
Kinosian BP, Eisenberg JM. Cutting into cholesterol: Cost-effective alternatives for treating hypercholesterolemia. JAMA 1988; 259: 2249–54.
Schulman KA, Kinosian B, Jacobson TA, et al. Reducing high blood cholesterol level with drugs: Cost effectiveness of pharmacologic management. JAMA 1990; 264: 2249–54.
Goldman L, Weinstein MC, Goldman PA, Williams LW. Cost-effectiveness of HMG-CoA reductase inhibition for primary and secondary prevention of coronary heart disease. JAMA 1991; 265: 1145–51.
Hamilton VH, Racicot F-E, Zowall H, Coupal L, Grover SA. The cost-effectiveness of HMGCoA reductase inhibitors to prevent coronary heart disease: Estimating the benefits of increasing HDL-C. JAMA 1995; 273: 1032–38.
Johanneson M, Jonsson B, Kjekshus J, Olsson AG, Pedersen TR, Wedel H, for the Scandinavian Simvastatin Survival Study Group. Cost effectiveness of simvastatin treatment to lower cholesterol levels in patients with coronary heart disease. N Engl J Med 1997; 336: 332–36.
Pedersen TR, Kjekshus J, Berg K, et al. Cholesterol lowering and the use of healthcare resources: Results of the Scandinavian Simvastatin Survival Study. Circulation 1996; 93: 1796–1802.
Ashraf T, Hay JW, Pitt B, et al. Cost-effectiveness of pravastatin in secondary prevention of coronary artery disease. Am J Cardiol 1996; 78: 409–14.
Shepherd J for the West of Scotland Coronary Prevention Study Economic Analysis Group. The cost-effectiveness of preventing initial coronary events with pravastatin. Results of the West of Scotland Coronary Prevention Study Economic Analysis. J Amer Coll Cardiol 1997; 29(Suppl.A, February):Abstract #968–54 (168A).
Anderson KM, Wilson PWF, Odell PM, Kannel WB. An updated coronary risk profile: A statement for health care professionals. Circulation 1991; 83: 356–62.
Pyorala K, De Backer G, Graham I, Poole-Wilson P, Wood D on behalf of the Task Force. Prevention of coronary heart disease in clinical practice. Recommendations of the Task Force of the European Society of Cardiology, European Atherosclerosis Society and European Society of Hypertension. Ear Heart J 1994; 15: 1300–31.
The West of Scotland Coronary Prevention Study Group. West of Scotland Coronary Prevention Study: Identification of high risk groups in comparison with other cardiovascular intervention trials. Lancet 1996; 348 (9038): 1339–42.
Ramsay LE, Haq IU, Jackson PR, Yeo WW, Pickin DM, Payne JN. Targeting lipid lowering drug therapy for primary prevention of coronary disease: An updated Sheffield table. Lancet 1996; 348: 387–88.
Shepherd J, for the West of Scotland Coronary Prevention Study Group. West of Scotland Coronary Prevention Study: Benefits of Pravastatin in compliant subjects. Circulation 1996; 94(Supp1.1):Abstract 3155.
Red Book Update. Montvale, NJ: Medical Economics Co., January 1997.
Bakker-Arkema RG, Davidson MH, Goldstein RJ, et al. Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia JAMA 1996; 275: 128–133.
Nawrocki JW, Weiss SR, Davidson MH, et al. Reduction of LDL cholesterol by 25% to 60% in patients with primary hypercholesterolemia by atorvastatin, a new HMG-CoA reductase inhibitor. Arterioscler Thromb Vasc Biol 1995; 15: 678–82.
Jacobson TA. Cost-effectiveness of 3-hydroxy-3-methylglutary-coenzyme A HMG-CoA reductase inhibitor therapy in the managed care era. Am J Cardiol 1996; 78 (Supp1.6A): 32–41.
Jacobson TA. Cost-effectiveness of 3-hydroxy-3-methylglutary-coenzyme A HMG-CoA reductase inhibitor therapy in the managed care era. Am J Cardiol 1996; 78 (Supp1.6A): 32–41.
Goldman L, Garber AM, Grover SA, Hlatky MA. Task Force 6. Cost effectiveness of assessment and management of risk factors. J Am Coll Cardiol 1996; 27 (5): 1020–30.
Wittels EH, Hay JW, Gotto AM Jr. Medical costs of coronary artery disease in the United States. Am J Cardiol 1990; 65: 432–40.
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Jacobson, T.A., Marchman, K.L. (1998). Improving the Cost Effectiveness of Lipid Lowering Therapy in Coronary Heart Disease Prevention. In: Gotto, A.M., Lenfant, C., Paoletti, R., Catapano, A.L., Jackson, A.S. (eds) Multiple Risk Factors in Cardiovascular Disease. Medical Science Symposia Series, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5022-4_32
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DOI: https://doi.org/10.1007/978-94-011-5022-4_32
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