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Gillespie, P,O'Shea, E,Murphy, AW,Byrne, MC,Byrne, M,Smith, SM,Cupples, ME
International Journal Of Technology Assessment In Health Care
The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease
Optional Fields
Coronary heart disease Secondary prevention General practice Cost-effectiveness analysis RANDOMIZED CONTROLLED-TRIAL PRIMARY-CARE CARDIOVASCULAR-DISEASE HEALTH RISK
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 (sic)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 (sic)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.
DOI 10.1017/S0266462310000358
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