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  • International Journal of Technology Assessment in Health Care, Volume 26, Issue 3
  • July 2010, pp. 263-271

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


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.

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1. M Barry , L Tilson . Recent developments in pricing and reimbursement of medicines in Ireland. Expert Rev Pharmacoecon Outcomes Res. 2007;7:605611.

2.JE Brazier , J Roberts . Estimating a preference-based index from the SF-12. Med Care. 2004;42:851859.

3.MK Campbell , DR Elbourne , DG Altman , CONSORT statement: Extension to cluster randomised trials. BMJ. 2004;328:702708.

6. AM Clark , L Hartling , B Vandermeer , FA McAlister . Meta-analysis: Secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143:659672.

7. ME Cupples , MC Byrne , SM Smith , C Leathem , AW Murphy . Secondary prevention of cardiovascular disease in different primary healthcare systems, with and without pay-for-performance. Heart. 2008;94:15941600.

8.RB D'Agostino , M Russell , DM Huse , Primary and subsequent coronary risk appraisal: New results from The Framingham Study. Am Heart J. 2000;139:272281.

9. G De Backer , E Ambrosioni , K Borch-Johnsen , European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2003;24:16011610.

14. K Johnston , A Gray , M Moher , Reporting the cost-effectiveness of interventions with nonsignificant effect differences: Example from the a trial of secondary prevention of heart disease. Int J Technol Assess Health Care. 2003;19:476489.

15.E Ketola , T Laatikainen , E Vartianinen . Evaluating risk for cardiovascular diseases -vain or value? How do different cardiovascular risk scores act in real life. Eur J Public Health. 2010;20:107112.

16. EA Lacey , SJ Walters . Continuing inequality: Gender and social class influences on self perceived health after a heart attack. J Epidemiol Community Health. 2003;57:622627.

17. A Manca , N Hawkins , M Sculpher . Estimating mean QALYs in trial based cost effectiveness analysis: The importance of controlling for baseline utility. Health Econ. 2005;14:487496.

18.AW Murphy , ME Cupples , S Smith , Secondary prevention of heart disease in general practice: A cluster randomised controlled trial of tailored practice and patient care plans. BMJ. 2009;339:b4220.

21. C O'Neill , C Normand , M Cupples , A McKnight . Cost effectiveness of personal health education in primary care for people with angina in the Greater Belfast area of Northern Ireland. J Epidemiol Community Health. 1996;50:538540.

22.JP Raftery , GL Yao , P Murchie , NC Campbell , LD Ritchie . Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: Follow up of a randomised controlled trial. BMJ. 2005;330:707.

23.M Robinson , S Palmer , M Sculpher , Cost effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: Systematic review and decision-analytical modelling. Health Technol Assess. 2005;9:iii-iv, ix-xi, 1158.

24. DA Turner , SK Paul , M Stone , Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care. Heart. 2008;94:16011606.

25.JE Ware , M Kosinski , SD Keller . A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220233.

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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
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