English, Article edition: Potential Costs and Effects of the National Service Framework for Coronary Heart Disease in the UK Venanzio Vella

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Bookmark: http://trove.nla.gov.au/version/93617
Physical Description
  • article
Language
  • English

Edition details

Title
  • Potential Costs and Effects of the National Service Framework for Coronary Heart Disease in the UK
Author
  • Venanzio Vella
Physical Description
  • article
Notes
  • Objective: To estimate the costs and effect of implementing the National Service Framework for Coronary Heart Disease (CHD) in the UK. Design: Decision trees were built on the results from randomised controlled trials on improving coronary revascularisation. All costs were presented in UK pounds (1997 values). Patients: Each year 6600 new patients with CHD are expected to require revascularisation in the UK. Interventions: The new patients would be equally divided into those undergoing coronary artery bypass grafting (CABG) and those undergoing a percutaneous coronary intervention (PCI) i.e., percutaneous transluminal angioplasty (PCTA). PTCA could be administered with or without abciximab (a glycoprotein IIb/​IIIa receptor antagonist), stent, or stent plus abciximab (stent+). Results: CABG/​stent alone has an incremental cost of more than Lstg 115 489 per additional quality-adjusted life-year (QALY) gained compared with CABG/​ PTCA+. This high incremental cost is not attractive because if CABG/​ stent would be added to abciximab (CABG/​stent+) its incremental cost-effectiveness ratio would be Lstg 2529 per extra QALY compared with CABG/​stent. Therefore, the debate should not be limited to the issue of stents but it should focus on the need for administering abciximab in addition to stent. The 5-year direct costs of implementing such a strategy in the UK is expected to be Lstg 50.6 million (1997 values). Conclusions: Abciximab and probably any glycoprotein IIb/​IIIa receptor antagonists should be added to any PCI, especially if stents are used.
  • Abciximab, Coronary disorders, Coronary interventions, Cost utility, GPIIb IIIa antagonists, Pharmacoeconomics
  • RePEc:wkh:phecon:v:21:y:2003:i:1:p:49-60
Language
  • English
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