Document Detail

Identifying favorable-value cardiovascular health services.
MedLine Citation:
PMID:  21756013     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To identify cardiovascular health services with a high level of evidence to suggest that they deliver favorable value.
STUDY DESIGN: Evidence synthesis using the Cost-Effectiveness Analysis Registry.
METHODS: We queried the registry to identify published cost-effectiveness analyses of cardiovascular health services in the United States. In addition to searching the registry, we performed supplementary searches of published literature for cost-effectiveness studies of cardiovascular interventions that were endorsed by guidelines of national medical and scientific societies. We defined favorable value as an incremental costeffectiveness ratio of $100,000 or less per qualityadjusted life-year.
RESULTS: Our initial review of cardiovascular health services in the United States revealed 174 separate peer-reviewed studies. Of those, 157 studies did not meet our inclusion criteria, leaving 17 studies for further evaluation that covered the following services with potentially high value: statins to prevent myocardial infarction (for primary and secondary prevention), screening for and treatment of high blood pressure (diuretics or beta-blockers and angiotensin-converting enzyme inhibitors in the case of diabetes) to prevent myocardial infarction and stroke, warfarin sodium and low-molecular-weight heparin to prevent pulmonary emboli, implantable cardiac defibrillators for patients at high risk of sudden death, antiplatelet drugs (aspirin and clopidogrel bisulfate) to prevent future myocardial infarction, beta-blockers for patients who have had myocardial infarction, warfarin to prevent future stroke in persons with nonvalvular atrial fibrillation, and percutaneous procedures to relieve claudication symptoms.
CONCLUSION: We describe a new way of synthesizing cost-effectiveness evidence for use by consumers, payers, and other decision makers.
R Scott Braithwaite; Sherry M Mentor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of managed care     Volume:  17     ISSN:  1936-2692     ISO Abbreviation:  Am J Manag Care     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-07-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431-8     Citation Subset:  H    
Section of Value and Comparative Effectiveness, Division of General Internal Medicine, NYU School of Medicine, 423 E 23rd St, 15th Floor, New York, NY 10010. E-mail:
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