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Title: | The cost-effectiveness of an early interventional strategy in non-ST-elevation acute coronary syndrome based on the RITA 3 trial |
Authors: | Henriksson, M Epstein, DM Palmer, SJ Sculpher, MJ Clayton, TC Pocock, SJ Henderson, RA Buxton, MJ Fox, KAA |
Issue Date: | 2008 |
Publisher: | British Medical Journal |
Citation: | Heart 94(6): 717-723, 2008 |
Abstract: | 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 £55000, £22000 and £12000 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 £20000 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. |
Description: | The published version of the aritcle can be found at the link below. |
URI: | http://bura.brunel.ac.uk/handle/2438/4628 |
DOI: | http://dx.doi.org/10.1136/hrt.2007.127340 |
ISSN: | 1355-6037 |
Appears in Collections: | Health Economics Research Group (HERG) |
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