BMJ 1996;313:1142 (2 November)

Letters

Cost effectiveness of lowering cholesterol

Cost consequence analysis may be more useful to decision makers

EDITOR,--If economic analyses are to provide guidance on population health strategies they should consider all relevant costs and consequences associated with medical interventions. We have identified five methodological deficiencies in the economic analysis of P D P Pharoah and W Hollingworth.1

Firstly, their study examines the impact of treatment only on death; it ignores the value of averting non-fatal consequences such as unstable angina, myocardial infarction, revascularisation procedures, and stroke. These consequences decrease both the length and quality of patients' lives.2 3 By failing to account for these supplementary outcomes, the analysis underestimates the reduction in risk attributed to treatment and the associated incremental life years gained.

Secondly, the net intervention cost may not adequately reflect the true number of myocardial infarctions averted. Seven myocardial infarctions would be averted for every four lives saved over six years in the population of . . . [Full text of this article]


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Relevant Article

Cost effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: life table method applied to health authority population
P D P Pharoah and W Hollingworth
BMJ 1996 312: 1443-1448. [Abstract] [Full Text]

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