[Health economic evaluation of low-dose acetylsalicylic acid in the primary prevention of cardiovascular disease].
OBJECTIVE
Low-dose aspirin is standard treatment for patients with a history of cardiovascular disease. Its use in primary prevention is more controversial. However, recent studies also support the use of aspirin in high-risk individuals with no history of cardiovascular disease. This study investigated the health economic implications of using low-dose aspirin in the primary prevention of cardiovascular disease in Spain.


METHODS
A model was developed to predict the cost-effectiveness of low-dose aspirin in the primary prevention of cardiovascular disease over a period of 10 years. The direct costs used were those of the Spanish National Health Service (NHS). Results were expressed as cost per life-year gained and per quality-adjusted life-year gained.


RESULTS
Administering low-dose aspirin to an individual with a 10-year risk of coronary heart disease > or =15% resulted in an average net saving of e 797 (95% CI, e 263-1331) over the 10-year period, with savings starting in the first year. For an annual risk > or =0.24%, this form of treatment would reduce NHS costs. Treating all at-risk individuals in the Spanish population with aspirin would save e 26.5 million from the healthcare budget, starting in the first year.


CONCLUSIONS
Administering low-dose aspirin to individuals with a 10-year risk of coronary heart disease > or =15% would result in significant cost savings for the Spanish NHS. Sensitivity analysis confirmed the robustness of these findings.
Lamotte
Mark
M
Health Economics and Disease Management Unit. IMS Health. Bruselas. Bélgica.
Piñol
Carme
C
Brotons
Carlos
C
Annemans
Lieven
L
Guardiola
Elena
E
Evers
Thomas
T
Kubin
Maria
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage* / Q000191:economics*; D002017:Budgets; D002318:Cardiovascular Diseases / Q000191:economics* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D013030:Spain
D001241:Aspirin