A Health Economic Evaluation of Aspirin in the Primary Prevention of Cardiovascular Disease in Japan

スポンサーリンク

概要

• 論文の詳細を見る

• Objective: Low-dose aspirin is standard care in patients with a history of cardiovascular disease (CVD). But, the use of low-dose aspirin in primary prevention has not yet been fully established in Japan although meta-analyses and US/European guidelines support its use in persons at increased CVD risk. This study assessed the health economic consequences of the use of low-dose aspirin in the primary prevention of CVD in Japan. Patients and Methods: Based on results reported in two recent meta-analyses of Hayden (2002) and Eidelman (2003), a Markov model was constructed to predict the cost-effectiveness of low-dose aspirin in the primary prevention of CVD. The model consists of 5 health states: 1) no history of CVD, 2) history of stroke, 3) history of myocardial infarction, 4) history of CVD, and 5) death, with a 10-year time horizon and 1-year cycles. Direct costs from the insurers perspective were used, while health outcome was expressed in Life-Years Gained (LYG). Discounting Rate with 3% was applied on effectiveness and costs. Results: For patients with a 1-year risk of coronary heart disease (CHD) of 1.5% (10-year risk of ±15%), the model demonstrated dominance of the aspirin arm versus no aspirin arm; the 10-year costs were Japanese Yen (JPY) 634,000 (Euro 4,857) and JPY 518,000 (Euro 3,968) in the no aspirin arm and aspirin arm, respectively, while LYG was 8.33 and 8.36, respectively. Low-dose aspirin treatment saved on average JPY 116,000 (Euro 889) [95% confidence interval (CI) JPY 57,077-175,151] per patient. Dominance was demonstrated (non-significant) in the first year of treatment and, low-dose aspirin was dominant to no aspirin arm from an annual risk of 0.20%. Other results of sensitivity analysis on gastrointestinal (GI) bleeding rate, stroke rate, cost of each event and discounting showed the robustness of the results. Conclusions: Administering low-dose aspirin to patients with a 1-year risk of CHD of 1.5% and more is significantly costsaving from the insurers perspective in Japan.

著者

• Fujikawa Keita

  Product Development Division Bayer Yakuhin Ltd

• Lamotte Mark

  HEDM

• Fujikawa Keita

  Product Development Division, Bayer Yakuhin Ltd.

• Tsutani Kiichiro

  The Department of Pharmacoeconomics, Graduate School of Pharmaceutical Sciences, The University of Tokyo

• Igarashi Ataru

  The Department of Pharmacoeconomics, Graduate School of Pharmaceutical Sciences, The University of Tokyo

• Evers Thomas

  Product Development Division, Bayer Health Care

• Kubin Maria

  Product Development Division, Bayer Health Care

• Annemans Lieven

  HEDM

関連論文

• Cost-Effectiveness Analysis of Hypertension Treatment : Controlled Release Nifedipine and Candesartan Low-Dose Combination Therapy in Patients with Essential Hypertension : The Nifedipine and Candesartan Combination (NICE-Combi) Study
• Up-titration of vardenafil dose from 10mg to 20mg improved erectile function in men with spinal cord injury
• Cost-Effectiveness Analysis : Controlled-Release Nifedipine and Valsartan Combination Therapy in Patients with Essential Hypertension : The Adalat CR and Valsartan Cost-Effectiveness Combination (ADVANCE-Combi) Study
• A Health Economic Evaluation of Aspirin in the Primary Prevention of Cardiovascular Disease in Japan

スポンサーリンク