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The cost-effectiven...
The cost-effectiveness of an early interventional strategy in non-ST-elevation acute coronary syndrome based on the RITA 3 trial
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- Henriksson, Martin (författare)
- Linköpings universitet,Medicinsk teknologiutvärdering,Hälsouniversitetet
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- Epstein, David (författare)
- Centre for Health Economics, University of York, UK
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- Palmer, Stephen (författare)
- Centre for Health Economics, University of York, UK
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- Sculpher, Mark (författare)
- Centre for Health Economics, University of York, UK
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- Clayton, Tim (författare)
- Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
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- Pocock, Stuart (författare)
- Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
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- Henderson, Robert (författare)
- Nottingham City Hospital NHS Trust, Nottingham UK
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- Buxton, Martin (författare)
- Health Economics Research Group, Brunel University, Uxbridge, UK
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- Fox, Keith A. A. (författare)
- Centre for Cardiovascular Science, Department of Medical and Radiological Sciences, University of Edinburgh, UK
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(creator_code:org_t)
- BMJ, 2008
- 2008
- Engelska.
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 94, s. 717-723
- Relaterad länk:
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http://urn.kb.se/res...
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https://heart.bmj.co...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Evidence suggests that an early interventional strategy for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can improve health outcomes but also increase costs when compared with a conservative strategy. Objective: The aim of this study was to assess the cost-effectiveness of an early interventional strategy in different risk groups from a UK health-service perspective. Design: Decision-analytic model based on randomised clinical trial data. Main outcome measures: Costs in UK Sterling at 2003/2004 prices and quality-adjusted life years (QALYs) combined into an incremental cost-effectiveness ratio. Methods: Data from the third Randomised Intervention Trial of unstable Angina (RITA 3) was employed to estimate rates of cardiovascular death and myocardial infarction, costs and health-related quality of life. Cost-effectiveness was estimated over patients’ lifetimes within the decision-analytic model. Results: The mean incremental cost per QALY gained for an early interventional strategy was approximately £55 000, £22 000 and £12 000 for patients at low, intermediate and high risk, respectively. The early interventional strategy is approximately 1%, 35% and 95% likely to be cost-effective for patients at low, intermediate and high risk, respectively, at a threshold of £20 000 per QALY. The cost-effectiveness of early intervention in low-risk patients is sensitive to assumptions about the duration of the treatment effect. Conclusion: An early interventional strategy in patients presenting with NSTE-ACS is likely to be considered cost-effective for patients at high and intermediate risk, but this is less likely to be the case for patients at low risk.
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- MEDICINE
- MEDICIN
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