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The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease

Published online by Cambridge University Press:  29 June 2010

Paddy Gillespie
Affiliation:
National University of Ireland, Galway
Eamon O'Shea
Affiliation:
National University of Ireland, Galway
Andrew W. Murphy
Affiliation:
National University of Ireland, Galway
Mary C. Byrne
Affiliation:
National University of Ireland, Galway
Molly Byrne
Affiliation:
National University of Ireland, Galway
Susan M. Smith
Affiliation:
Trinity College Dublin
Margaret E. Cupples
Affiliation:
Queen's University Belfast

Abstract

Objectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland.

Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care.

Results: The intervention strategy resulted in mean cost savings per patient of €512.77 (95 percent confidence interval [CI], −1086.46–91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, −0.0101–0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay €45,000 per additional QALY.

Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice.

Type
ASSESSMENTS
Copyright
Copyright © Cambridge University Press 2010

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