title: What is the economic impact of secondary prevention to society?
abstract: Of the 4.1 million population of Norway about 7500 patients between 20 and 75 years of age are admitted each year to hospital for acute myocardial infarction. Of these 1100 die in hospital, and 6400 are candidates for secondary prevention. On the basis of survival curves, we present a model for calculating potential benefits of secondary prevention. We use 'years of life gained' as a measure of outcome of secondary prevention. We consider three economic elements in secondary prevention: (a) Use of health services. The drug costs are moderate. The indirect costs are unknown, but probably moderate. (b) Resumed productivity is small. (c) Pensions and other transfers will increase the public expense. The net effect is an increase in public expense. Beta blockers reduce mortality by 25% and can be given prophylactically to about one third of the patients. So far, the effect is uncertain after two years. Secondary prevention for two years will cost Norway about 3.8 million NOK (526 000 US +) per year for drugs, give 597 extra survivors and provide 0.24 additional life years per patient treated. In case of life-long treatment and effect, the result will be 1.6 years of life per patient treated. About 50% of Norwegian patients smoke. If all the men stopped, there will be no costs, about 5120 extra survivors, and 3.3 additional years of life per patient who quits smoking. The effect is not limited in time.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009203:Myocardial Infarction / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D009664:Norway; D012306:Risk; D012907:Smoking; D012959:Socioeconomic Factors
chemical_list: D000319:Adrenergic beta-Antagonists