Resource implications and health benefits of primary prevention strategies for cardiovascular disease in people aged 30 to 74: mathematical modelling studyBMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7367.756 (Published 05 October 2002) Cite this as: BMJ 2002;325:756
The authors of this primary care paper, Tom Marshall and Andrew Rouse, have alerted us to some errors in the costings given for the follow up of patients (27 July, pp 197-9). They have confirmed that despite this the conclusions of the article remain the same.
Firstly, in table 2 in the web version (bmj.com), the costs should read, downwards: £3567; £18 290; £32 628; £3567; £6758; £24 489; £36 233; £14 983; £25 975; £46 270; and £34 950. The heading for that column should read: “Cost per event prevented.”
Secondly, the first three paragraphs of the results section should read as below.
Technical efficiency: maximising benefits within total resources
For any given allocation of resources to primary prevention of cardiovascular disease more cardiovascular events can be prevented under RM strategies than the equivalent JBR strategies. A primary care team can prevent 5.7 events for £40 934 under strategy RM-2 or 5.7 events for £28 090 under RM-3. The most efficient strategy for a primary care team with a budget of £40 934 is therefore RM-3. A primary care team can prevent 7.6 events for £116 233 under strategy RM-1 or 7.6 events for £86 696 under RM-2. The most efficient strategy for a primary care team with a budget of £116 233 is therefore RM-2. For a primary care team with a budget of over £116 233 the most efficient strategy is RM-1.
Maximising efficiency within available clinical staff time
[After second sentence] At one clinic a month there is not sufficient clinical time to assess all eligible adults. JBR strategies therefore cannot be implemented. Strategy RM-3 can prevent 4.0 cardiovascular events at a cost of £3567 per event prevented. RM-2 can prevent 1.1 more events at an incremental cost of £18 290 per event prevented. RM-1 can prevent 2.5 more events than RM-2 at an incremental cost of £32 628 per event prevented.
Compared with one clinic a month, allocating two clinics a month to RM-3 can prevent 1.6 more events at a cost of £6758 per event prevented. Allocating two clinics a month to RM-2 prevents a further 1.7 events at an incremental cost of £24 489 per event prevented. Two clinics a month following strategy RM-1 prevents a further 3.5 cardiovascular events at an incremental cost of £36 233 per event prevented.