Costs and cost effectiveness of cardiovascular screening and intervention: the British family heart study.
OBJECTIVE
To measure costs and cost effectiveness of the British family heart study cardiovascular screening and intervention programme.


METHODS
Cost effectiveness analysis of randomised controlled trial. Clinical and resource use data taken from trial and unit cost data from external estimates.


METHODS
13 general practices across Britain.


METHODS
4185 men aged 40-59 and their 2827 partners.


METHODS
Nurse led programme using a family centered approach, with follow up according to degree of risk.


METHODS
Cost of the programme it self; overall short term cost to NHS; cost per 1% reduction in coronary risk at one year.


RESULTS
Estimated cost of putting the programme into practice for one year was 63 pounds per person (95% confidence interval 60 pounds to 65 pounds). The overall short term cost to the health service was 77 pounds per man (29 pounds to 124 pounds) but only 13 pounds per woman (-48 pounds to 74 pounds), owing to differences in utilisation of other health service resources. The cost per 1% reduction in risk was 5.08 pounds per man (5.92 pounds including broader health service costs) and 5.78 pounds per woman (1.28 pounds taking into account wider health service savings).


CONCLUSIONS
The direct cost of the programme to a four partner practice of 7500 patients would be approximately 58,000 pounds. Annually, 8300 pounds would currently be paid to a practice of this size working to the maximum target on the health promotion bands, plus any additional reimbursement of practice staff salaries for which the practice qualified. The broader short term costs to the NHS may augment these costs for men but offset them considerably for women.
Wonderling
D
D
Health Economics Research Group, Brunel University, Uxbridge, Middlesex.
McDermott
C
C
Buxton
M
M
Kinmonth
A L
AL
Pyke
S
S
Thompson
S
S
Wood
D
D
D000328:Adult; D003327:Coronary Disease / Q000191:economics / Q000451:nursing / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D004739:England; D005192:Family Health; D005194:Family Practice / Q000191:economics*; D005260:Female; D006302:Health Services Research / Q000191:economics*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D012307:Risk Factors