Utility Loss and Indirect Costs Following Cardiovascular Events in Hypertensive Patients: the ASCOT Health Economic Substudy

Overview

Journal Eur J Health Econ

Specialty Health Services

Date 2006 Dec 14

PMID 17165074

Citations 14

Authors

Peter Lindgren

Thomas Kahan

Neil Poulter

Martin Buxton

Patrick Svarvar

Bjorn Dahlof

Bengt Jonsson

Affiliations

Soon will be listed here.

Abstract

This study assessed the loss of utility and indirect costs associated with first cardiovascular events. Data was collected (using EQ-5D) prospectively at 3, 6, and 12 months following an event in the Swedish part of the Anglo-Scandinavian cardiac outcomes trial (ASCOT), including patients with mild to moderate hypertension and additional risk factors. Sixty patients were eligible for analysis. An event was associated with a one-year utility loss of 0.075 (95% CI: 0.038-0.114). For a stroke, the reduction was 0.145 (CI: 0.059-0.249) and for acute coronary syndromes (myocardial infarction or unstable angina) the loss was 0.051 (-0.003 to 0.103). The utility at baseline was no different to the utility in a control group. The indirect cost over the first 12 months (2003 Swedish Kronor, SEK) was 90028 SEK (CI: 46027-146754), 9866 euro for patients in the workforce. These results are helpful in future economic evaluations of primary preventive measures in cardiovascular medicine.

Citing Articles

Different strategies for pharmacological thromboprophylaxis for lower-limb immobilisation after injury: systematic review and economic evaluation.

Pandor A, Horner D, Davis S, Goodacre S, Stevens J, Clowes M Health Technol Assess. 2019; 23(63):1-190.

PMID: 31851608 PMC: 6936165. DOI: 10.3310/hta23630.

A cost-effectiveness analysis of a community based CVD program in Sweden based on a retrospective register cohort.

Lindholm L, Stenling A, Norberg M, Stenlund H, Weinehall L BMC Public Health. 2018; 18(1):452.

PMID: 29618323 PMC: 5885416. DOI: 10.1186/s12889-018-5339-3.

Does a hospital admission in old age denote the beginning of life with a compromised health-related quality of life? A longitudinal study of men and women aged 65 years and above participating in the Stockholm Public Health Cohort.

Karampampa K, Frumento P, Ahlbom A, Modig K BMJ Open. 2016; 6(7):e010901.

PMID: 27401358 PMC: 4947764. DOI: 10.1136/bmjopen-2015-010901.

Work productivity loss and indirect costs associated with new cardiovascular events in high-risk patients with hyperlipidemia: estimates from population-based register data in Sweden.

Banefelt J, Hallberg S, Fox K, Mesterton J, Paoli C, Johansson G Eur J Health Econ. 2015; 17(9):1117-1124.

PMID: 26607457 PMC: 5080301. DOI: 10.1007/s10198-015-0749-y.

Cost effectiveness of a pharmacist-led information technology intervention for reducing rates of clinically important errors in medicines management in general practices (PINCER).

Elliott R, Putman K, Franklin M, Annemans L, Verhaeghe N, Eden M Pharmacoeconomics. 2014; 32(6):573-90.

PMID: 24639038 DOI: 10.1007/s40273-014-0148-8.

References

Brooks R . EuroQol: the current state of play. Health Policy. 1996; 37(1):53-72. DOI: 10.1016/0168-8510(96)00822-6. View

Burstrom K, Johannesson M, Diderichsen F . Swedish population health-related quality of life results using the EQ-5D. Qual Life Res. 2002; 10(7):621-35. DOI: 10.1023/a:1013171831202. View

Sever P, Dahlof B, Poulter N, Wedel H, Beevers G, Caulfield M . Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial. ASCOT investigators. J Hypertens. 2001; 19(6):1139-47. DOI: 10.1097/00004872-200106000-00020. View

Clarke P, Gray A, Holman R . Estimating utility values for health states of type 2 diabetic patients using the EQ-5D (UKPDS 62). Med Decis Making. 2002; 22(4):340-9. DOI: 10.1177/0272989X0202200412. View

Oldridge N, Furlong W, Feeny D, Torrance G, Guyatt G, Crowe J . Economic evaluation of cardiac rehabilitation soon after acute myocardial infarction. Am J Cardiol. 1993; 72(2):154-61. DOI: 10.1016/0002-9149(93)90152-3. View

Sever P, Dahlof B, Poulter N, Wedel H, Beevers G, Caulfield M . Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre.... Lancet. 2003; 361(9364):1149-58. DOI: 10.1016/S0140-6736(03)12948-0. View

. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990; 16(3):199-208. DOI: 10.1016/0168-8510(90)90421-9. View

Lindgren P, Buxton M, Kahan T, Poulter N, Dahlof B, Sever P . Cost-effectiveness of atorvastatin for the prevention of coronary and stroke events: an economic analysis of the Anglo-Scandinavian Cardiac Outcomes Trial--lipid-lowering arm (ASCOT-LLA). Eur J Cardiovasc Prev Rehabil. 2005; 12(1):29-36. View

Tsevat J, Goldman L, Soukup J, Lamas G, Connors K, Chapin C . Stability of time-tradeoff utilities in survivors of myocardial infarction. Med Decis Making. 1993; 13(2):161-5. DOI: 10.1177/0272989X9301300210. View

10.

Zethraeus N, Molin T, Henriksson P, Jonsson B . Costs of coronary heart disease and stroke: the case of Sweden. J Intern Med. 1999; 246(2):151-9. DOI: 10.1046/j.1365-2796.1999.00546.x. View

11.

Jonsson B, Buxton M, Kahan T, Poulter N, Svarvar P . The effects of cardiac events on quality of life and indirect costs. J Hum Hypertens. 2001; 15 Suppl 1:S91-3. DOI: 10.1038/sj.jhh.1001214. View

12.

Post P, Stiggelbout A, Wakker P . The utility of health states after stroke: a systematic review of the literature. Stroke. 2001; 32(6):1425-9. DOI: 10.1161/01.str.32.6.1425. View

13.

Dahlof B, Sever P, Poulter N, Wedel H, Beevers D, Caulfield M . Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm.... Lancet. 2005; 366(9489):895-906. DOI: 10.1016/S0140-6736(05)67185-1. View

14.

Dorman P, Dennis M, Sandercock P . Are the modified "simple questions" a valid and reliable measure of health related quality of life after stroke? United Kingdom Collaborators in the International Stroke Trial. J Neurol Neurosurg Psychiatry. 2000; 69(4):487-93. PMC: 1737115. DOI: 10.1136/jnnp.69.4.487. View

15.

Dolan P, Roberts J . Modelling valuations for Eq-5d health states: an alternative model using differences in valuations. Med Care. 2002; 40(5):442-6. DOI: 10.1097/00005650-200205000-00009. View