John B. Wong, MD
Potential Financial Conflicts of Interest: Dr. Wong is a medical editor for the Foundation for Informed Medical Decision Making.
Wong JB. Clarifying the Principles of Cost-Effectiveness Analyses. Ann Intern Med. 2009;151:142. doi: 10.7326/0003-4819-151-2-200907210-00017
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Published: Ann Intern Med. 2009;151(2):142.
Cost-effectiveness analysis enables policymakers to maximize outcomes without exceeding available resources by determining either the greatest possible benefit for a given resource or the lowest resource cost for a given benefit. To illustrate, Pletcher and colleagues (1) estimated average annual discounted health care costs of $897.64 billion (Table 2) for 138.6 million men and women age 35 to 85 years at baseline, yielding an average cost of $6477 per treated or untreated person. The next most expensive policy options were treating persons with 10-year coronary heart disease (CHD) risk greater than 15% or adhering to Adult Treatment Panel III (ATP III) guidelines, which would cost $6487 or $6503 per person, respectively. So for all 3 of these policies, about 154 individuals could be covered per year for statin primary prevention with an annual budget of $1 million.
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