Evaluación clínica y económica según el grado de riesgo cardiovascular en sujetos pertenecientes a un ámbito poblacional español

Sicras‐Mainar, Antoni; Velasco-Velasco, Soledad; Guix, Nuria González-Rojas; Rodríguez-Cid, José Luis

doi:10.1157/13124104

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Another strength is that all of the costs used in the study were taken from Spanish sources [ 36 – 38 ]. In particular, the costs associated with the CHD risk states were obtained from a Spanish cross-sectional study using a retrospective review of the medical records of 12,828 patients followed up as outpatients in seven primary care centers [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interval: ±2.6 % e Utility 10 % less than that of the CHD, in accordance with Ara et al [ 31 ] f Utility in the years following CHD (unstable angina and myocardial infarction). Interval: ±2.6 % g Total cost of a patient in primary care, according to CHD risk [ 36 ] h Average cost of the following DRGs: 121, 122, 123, and 140. Interval: cost of DRG 140 (minimum) and 123 (maximum) i It is assumed that the cost of the state of chronic CHD corresponds to a very high CHD risk (≥30 % on the Framingham scale) [ 36 ]…”

Section: Methodsmentioning

confidence: 99%

“…i It is assumed that the cost of the state of chronic CHD corresponds to a very high CHD risk (≥30 % on the Framingham scale) [ 36 ]…”

Section: Methodsmentioning

confidence: 99%

“…The analysis was made from the NHS perspective, and thus only direct health costs were included. The unit costs of the health states are from Spanish sources [ 36 , 37 ] and are shown in Table 4 .…”

Section: Methodsmentioning

confidence: 99%

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Economic Evaluation of Cardio inCode®, a Clinical-Genetic Function for Coronary Heart Disease Risk Assessment

Arellano

Coca

Figuera

et al. 2013

Appl Health Econ Health Policy

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Background A clinical-genetic function (Cardio inCode Ò ) was generated using genetic variants associated with coronary heart disease (CHD), but not with classical CHD risk factors, to achieve a more precise estimation of the CHD risk of individuals by incorporating genetics into risk equations [Framingham and REGICOR (Registre Gironí del Cor)]. Objective The objective of this study was to conduct an economic analysis of the CHD risk assessment with Cardio inCode Ò , which incorporates the patient's genetic risk into the functions of REGICOR and Framingham, compared with the standard method (using only the functions). Methods A Markov model was developed with seven states of health (low CHD risk, moderate CHD risk, high CHD risk, CHD event, recurrent CHD, chronic CHD, and death). The reclassification of CHD risk derived from genetic information and transition probabilities between states was obtained from a validation study conducted in cohorts of REGICOR (Spain) and Framingham (USA). It was assumed that patients classified as at moderate risk by the standard method were the best candidates to test the risk reclassification with Cardio inCode Ò . The utilities and costs (€; year 2011 values) of Markov states were obtained from the literature and Spanish sources. The analysis was performed from the perspective of the Spanish National Health System, for a life expectancy of 82 years in Spain. An annual discount rate of 3.5 % for costs and benefits was applied. Results For a Cardio inCode Ò price of €400, the cost per QALY gained compared with the standard method [incremental cost-effectiveness ratio (ICER)] would be €12,969 and €21,385 in REGICOR and Framingham cohorts, respectively. The threshold price of Cardio inCode Ò to reach the ICER threshold generally accepted in Spain (€30,000/QALY) would range between €668 and €836. The greatest benefit occurred in the subgroup of patients with moderate-high risk, with a high-risk reclassification of 22.8 % and 12 % of patients and an ICER of €1,652/QALY and €5,884/QALY in the REGICOR and Framingham cohorts, respectively. Sensitivity analyses confirmed the stability of the study results. Conclusions Cardio inCodeÒ is a cost-effective risk score option in CHD risk assessment compared with the standard method.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…i It is assumed that the cost of the state of chronic CHD corresponds to a very high CHD risk (≥30 % on the Framingham scale) [ 36 ]…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Economic Evaluation of Cardio inCode®, a Clinical-Genetic Function for Coronary Heart Disease Risk Assessment

Arellano

Coca

Figuera

et al. 2013

Appl Health Econ Health Policy

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“…In the Netherlands, official data on costs for lung cancer, CHD, stroke and COPD were available 23. Costs of smoking‐related diseases were obtained from the literature in Germany 24, 25, 26, 27 and Spain 28, 29, 30, 31, 32. Further details are found in country‐specific technical annexes 16, 17, 18, 19, 20.…”

Section: Methodsmentioning

confidence: 99%

Estimates of costs for modelling return on investment from smoking cessation interventions

Trapero-Bertran

Leidl²,

Muñoz

et al. 2018

Addiction

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Background and aimsModelling return on investment (ROI) from smoking cessation interventions requires estimates of their costs and benefits. This paper describes a standardized method developed to source both economic costs of tobacco smoking and costs of implementing cessation interventions for a Europe‐wide ROI model [European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD)].DesignFocused search of administrative and published data. A standardized checklist was developed in order to ensure consistency in methods of data collection.Setting and participantsAdult population (15+ years) in Hungary, Netherlands, Germany, Spain and England. For passive smoking‐related costs, child population (0–15 years) was also included.MeasurementsCosts of treating smoking‐attributable diseases; productivity losses due to smoking‐attributable absenteeism; and costs of implementing smoking cessation interventions.FindingsAnnual costs (per case) of treating smoking attributable lung cancer were between €5074 (Hungary) and €52 106 (Germany); coronary heart disease between €1521 (Spain) and €3955 (Netherlands); chronic obstructive pulmonary disease between €1280 (England) and €4199 (Spain); stroke between €1829 (Hungary) and €14 880 (Netherlands). Costs (per recipient) of smoking cessation medications were estimated to be: for standard duration of varenicline between €225 (England) and €465 (Hungary); for bupropion between €25 (Hungary) and €220 (Germany). Costs (per recipient) of providing behavioural support were also wide‐ranging: one‐to‐one behavioural support between €34 (Hungary) and €474 (Netherlands); and group‐based behavioural support between €12 (Hungary) and €257 (Germany). The costs (per recipient) of delivering brief physician advice were: €24 (England); €9 (Germany); €4 (Hungary); €33 (Netherlands); and €27 (Spain).ConclusionsCosts of treating smoking‐attributable diseases as well as the costs of implementing smoking cessation interventions vary substantially across Hungary, Netherlands, Germany, Spain and England. Estimates for the costs of these diseases and interventions can contribute to return on investment estimates in support of national or regional policy decisions.

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Cost‐effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD

et al. 2018

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AimsTo assess the cost‐effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS).DesignWe used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov‐based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self‐helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion. A rate of 3% was used to discount life‐time costs and benefits.SettingSpain.ParticipantsAdult smoking population (16+ years).MeasurementsHealth‐care costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality‐adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates.FindingsThe cost of implementing the current provision of smoking cessation services is approximately €61 million in the current year. This translates to 18 quitters per 1000 smokers and a life‐time benefit–cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost‐saving: less expensive to run and generated more QALYs) from the life‐time perspective, compared with the current provision. The life‐time benefit–cost ratios were: 1.87 (proactive telephone calls); 1.17 (Rx NRT); 2.40 (varenicline‐standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis.ConclusionsAccording to the EQUIPTMOD modelling tool it would be cost‐effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro‐active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run.

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Evaluación clínica y económica según el grado de riesgo cardiovascular en sujetos pertenecientes a un ámbito poblacional español

Cited by 4 publications

References 9 publications

Economic Evaluation of Cardio inCode®, a Clinical-Genetic Function for Coronary Heart Disease Risk Assessment

Economic Evaluation of Cardio inCode®, a Clinical-Genetic Function for Coronary Heart Disease Risk Assessment

Estimates of costs for modelling return on investment from smoking cessation interventions

Cost‐effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD

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