| アブストラクト | OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012. PARTICIPANTS: Patients >/=18 years who had a CV event and received at least 2 lipid-modifying therapy prescriptions within 180 days beforehand. PRIMARY AND SECONDARY OUTCOME MEASURES: Direct medical costs (2014 pound) were estimated in 3 periods: baseline (pre-event), acute (6 months afterwards) and long-term (subsequent 30 months). Primary outcomes included incremental costs, resource usage and total costs per period. RESULTS: There were 24 093 patients in the first event cohort of whom 5274 were included in the second event cohort. The mean incremental acute CV event costs for the first event and second event cohorts were: coronary artery bypass graft/percutaneous transluminal coronary angioplasty (CABG/PTCA) pound5635 and pound5823, myocardial infarction pound4275 and pound4301, ischaemic stroke pound3512 and pound4572, heart failure pound2444 and pound3461, unstable angina pound2179 and pound2489 and transient ischaemic attack pound1537 and pound1814. The mean incremental long-term costs were: heart failure pound848 and pound2829, myocardial infarction pound922 and pound1385, ischaemic stroke pound973 and pound682, transient ischaemic attack pound705 and pound1692, unstable angina pound328 and pound677, and CABG/PTCA pound-368 and pound599. Hospitalisation accounted for 95% of acute and 61% of long-term incremental costs. Higher comorbidity was associated with higher long-term costs. CONCLUSIONS: Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden. |
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| 投稿者 | Danese, Mark D; Gleeson, Michelle; Kutikova, Lucie; Griffiths, Robert I; Azough, Ali; Khunti, Kamlesh; Seshasai, Sreenivasa Rao Kondapally; Ray, Kausik K |
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| 組織名 | Outcomes Insights, Inc., Outcomes Research, Westlake Village, California, USA.;Amgen (Europe) GmbH, Health Economics, Zug, Switzerland.;Outcomes Insights, Inc., Outcomes Research, Westlake Village, California, USA;University of Oxford, Oxford, UK.;Amgen Ltd, Health Economics, Uxbridge, Middlesex, UK.;Diabetes Research Centre, University of Leicester, Leicester, UK.;St George's, University of London, London, UK.;Department of Medicine, School of Public Health, Imperial College London, London,;UK. |
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