Open AccessCombination Polypharmacy for Cardiovascular Disease Prevention in Men: A Decision Analysis and Cost‐Effectiveness Model
Author(s) -
Newman Jonathan,
Grobman William A.,
Greenland Philip
Publication year - 2008
Publication title -
preventive cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-7141
pISSN - 1520-037X
DOI - 10.1111/j.1520-037x.2007.06423.x
Subject(s) - medicine , polypharmacy , atenolol , hydrochlorothiazide , dyslipidemia , fixed dose combination , cost effectiveness , quality adjusted life year , intensive care medicine , disease , blood pressure , risk analysis (engineering)
Pharmacotherapies to lower blood pressure and cholesterol are effective in the primary prevention of cardiovascular disease (CVD). The use of fixed‐dose medication combinations has not been well studied. The authors created a Markov model to analyze the cost‐effectiveness of 4 fixed‐dose medications for primary CVD prevention in men. The initial decision node was to treat or not treat men older than 55 years, without CVD, hypertension, or dyslipidemia with a combination of simvastatin, captopril, hydrochlorothiazide, and atenolol. Probability, costs, and effectiveness were derived from the literature. The outcome variable was marginal cost per quality‐adjusted life‐year (QALY). Sensitivity analyses were performed. The average cost of treatment was $70,000 compared with $93,000 for non‐treatment. Treatment resulted in 13.62 QALYs vs 12.96 QALYs without treatment. Primary prevention of CVD with fixed‐dose medications dominated “no‐treatment.” The use of a fixed‐dose polypharmacy approach to CVD prevention in men older than 55 years may be cost‐effective.